Information form

First Name

Last Name

Company

Address

Email Address

Phone Number

Do you currently have a website? Do you currently have a website? Yes No

If so, what's the address?

Do you have a domain name registered (provide 3 options)

Do you have hosting? Do you have hosting? Yes No

Do you currently have a logo or corporate colors? Do you have any content at the moment?

What is the website's main purpose? What is the website's main purpose? To sell products To promote services to collect email addresses to build a brand/community

What is the desired outcome from a visitor arriving at the website? What is the desired outcome from a visitor arriving at the website? To leave an email address To make a purchase To contact you To fill out a form Other (Please specify )

Specify desired outcome

Do you want any of the following? Do you want any of the following? Blog Social sharing icons Links to social profiles Contact form Email signup form/ ability to collect emails Ability to sell digital products Ability to sell physical products Other (please specify)

Specify other features you would like

How would you best describe your brand

Who is your target audience?

How many pages will the website have roughly? How many pages will the website have roughly? 1-10 10-30 30+

Please provide the page names you would like (e.g. home, about, contact, etc)

Ideally, when would you like the website completed?

Two or three websites you admire or would like to emulate:

Further comments