Quote Request

Quote Request

If you're interested in my design services, please fill out the following form:

* notes a required field.

Opening Information
Real Name *
Email Address *
Phone Number
Payment Information
Budget $30-$100
$100-$150
$150-$500
$500-$1,000
$1,000 - $5,000
$5,000 - $10,000
$10,000 +
Other (please specify below)
Other: 		*
Payment Type I will only accept the following forms of payment. Please select your preference:
Cash
Certified Check
Credit Card
Money Order
PayPal 		*
Time Frame When would you like this project completed? Please note that these timeframes are from the start date. I can not complete a project within 24 hours of your submitting this message.
24-Hours
1 Week / 7 Days
2 Weeks / 14 Days
3 Weeks / 21 Days
4 Weeks / 30 Days
More than 30 Days
Other (please specify below)
Other: 		*
Website Information
Domain & Hosting I need a domain and hosting.
I have a domain and need hosting.
I do not need a domain or hosting.
Website URL
Website Title
Website Platform Personal Website
Small Business
Corporate / Large Business
Non-Profit Organization
Weblog Website
Miscellaneous Website
Other (please specify)
Other:
Website Description Please describe your website to me in full detail.
Design Information
How can I help you? Please describe, in full detail, exactly what you're looking for in a design from me. Please make sure to include colors, fonts, images, etc.
Template Ideas Please list two-four websites that house the style you're looking for in your template. This will give me a better idea of exactly what you'd like done and what your personal tastes are so I can design a template that suits you.
Scripting Are you looking for any PHP scripting. This would include the installation of pre-written scripts (IE: Wordpress, PHPBB) or would you require any custom written scripts (IE: forms, social networking, galleries, shopping carts, etc.) from my programmer? (PHP only)
Customization & Extras Will your template require any extras such as plug-ins, custom features, etc.
In Closing
Comments or Questions

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