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Request a Custom Web Site Solution

Do you want to redesign an existing web site or are you requesting a proposal for a new project?

New Project: Redesign:

If you haven't already reserved a domain name, it would be in your best interest to do so
before somebody steals your identity. Reserve your domain name today.

( If Redesign, Enter URL )

What type of the web site do you wish to put on the Internet?

Approximately how many pages do want redesigned or created?

How many custom images do you want created for web site?

Do you already have a logo for your web site?
If no, would you like us to create you one?

Yes No
Yes No

Will you require any of the following forms on web site?
Contact Form	Subscription Form	If other, what type...
Ordering Form	Other forms

Do you want any of the following files to be available from your web site?
	.Exe	How many?	Will you be supplying the file(s)? Yes No
	Docs.	How many?	Will you be supplying the file(s)? Yes No
	Flash	How many?	Will you be supplying the file(s)? Yes No
	Video	How many?	Will you require media encoding? Yes No
	Audio	How many?	Will you require media encoding? Yes No

Will you require any password protect areas of web site? Yes No

Do you need www.h-webdesign.com to regularly update web site?
WeeklyMonthly Quarterly No

Do you wish to have your web site translated into other languages?
Yes No
If yes, which language(s)?

Would like to have a custom ad banner created to help promote company?
Yes No

Would you like to advertise web site on our banner exchange network?
Yes No

Would you like to have your site submitted to over 13,000 search engines and directories?
Yes No

Would you like to host your web site on our web servers?
Yes No


Please Enter Your Contact Information:

Email:
Name:
Web Site:
Company:
Phone:
Fax:

Questions or Comments: