Website Design 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/Zipcode:
Country:
Telephone:
E-Mail Address:

Type of Web Package:
	6-page Web Package - One Home Page with 5 additional pages including 1 form. (£350)
	10-page Web Package - One Home Page with 9 additional pages including 1 form. (£500)
	15-page Web Package - One Home Page with 14 additional pages including 2 forms. (£650)
	20-page Web Package - One Home Page with 19 additional pages including 2 forms. (£800)

Objective/purpose of website:

To establish a presence on the Internet and the World Wide Web.
To advertise product information and price lists to customers.
To sell products directly taking credit card information over the Internet
To have potential customers contact you by phone or mail.
Other

Domain Name Registration
While we ourselves do not register Domain Names yet, we can carry out the search and purchase your desired name fro 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)

Navigation and Layout Design:
Top of page Navigation Bar?	Yes No
Side of page Navigation Bar?	Yes No
Bottom of page Navigation Bar?	Yes No
E-Mail response link(s)?	Yes No
Copyright at bottom of pages?	Yes No
Estimated number of pages:

Web Page Content:
Graphic(s):	Yes No	Estimated #:
Standard company information:	Yes No
E-mail response link:	Yes No
Copyright on each page:	Yes No
May we include a link to "Designed by Nukan Web Services"?	Yes No
Other:

Graphics:
Company Logo?	Yes No
Photos?	Yes No	Estimated #
Other Graphic Images/Clipart?	Yes No	Estimated #
Need scanning of images?	Yes No	Estimated #
Need custom designed graphics?	Yes No	Estimated #

Forms for Customer Response:
Customer Feedback / Comments	Yes No
On-Line Orders	Yes No
Other forms (Please give details)

Custom Design Considerations
(Please list any other special needs)

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

Special Offers