BizCard Request Form

This form is designed to assist us in planning your web pages, site design and layout. (Please complete and submit this information using the form below.)

Client / Organisation Information:
Company Name:
First Name:
Last Name:
Address 1:
Address 2:
City:
County/Province/State:
Postcode/Zip code:
Country:
Telephone:
E-Mail Address:

Type of Web Package:
	BizCard Web Page (Basic - with NukanWeb branding - £15 setup fee) £5 per month
	BizCard Web Page (Premium - without NukanWeb branding - £30 setup fee) £5 per month

Domain Name Registration
While we ourselves do not register Domain Names yet, we have teamed up with LYCOS can carry out the search for your desired name for you at NO Extra Charge.
Desired Domain Name: (Example: companyname.com)
Please enter your second choice: (Example: companyname.co.uk)
Desired E-Mail address: (support@yourbusiness.com)

Index/Home Page:
Page Title (To appear at the top of the Web browser and will show on listing by web search engines)
Page Description (200 characters or less to be used by search engines)
Keywords which people might use to find your company product or service (separate words with commas)

Web Page Format Elements:- (Premium Option Only)
Desired Text Colour:	Please use Hexidecimal code.
Desired Typeface:
Size of normal text type: (relative to the user's settings in browser)
Desired Background Colour or Texture:A white background with a band of color on the left margin offers the best readability and contrast.	Please use Hexidecimal code.
Website ThemeColour	Please use Hexidecimal code.

Custom Design Considerations

Thank you for completing this form. We shall get back to you soon.

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