Your Full Name
Your eMail Address
How do you connect to the Internet now?
What Operating System platform are you using in your business?
I don't know
What Operating System are you using for your PCs?
Include Windows or MAC, and Revision (2000, XT, XT Pro, Vista, W98)
What Browser are you using?
Typically IE6, IE7, FireFox, Mozilla, Opera, etc.
Do you wish to maintain
your web site in-house?
I want to consider
I do not know
If you indicated "Yes", or "Consider" previously, briefly indicate
your staff's familiarity and skill level with these programs. These are to help us assess the
level of Site Editor you may need.
Is there information you need to share confidentially with
I need to think more about
Are you interested in posting job openings on your web site?
Does your business anticipate storing large documents on the web
server. Examples might be accounting reports, technical drawings, architectural drawings, project
files, schedules, medical records, and so on. If yes, briefly describe the type of document. If you
can, provide a average files size and guesstimate number of files.
Possibly, I need more info on this.
Think of routine tasks that your business performs that might be
handled electronically - in part or in total.
List them 1 per line
Listed at right are some common web site page titles. Check off any
that you feel you need to have on your web site.
Listed at right are several web site application modules. Without
putting limitations on them due to cost, please check off those that might be of interest to your
business. It is not necessary that you understand precisely what they are used for.
List at least 1 URL and no more than 3 web sites that you like (not necessarily in your
industry or a competitor). These are web sites you like, you think are nicely designed, and that
you would go back and visit again.
I wish to have my web site online by this date:
Please make any comments or points you feel would be valuable in
assessing your web site and Internet application needs.