|
Design Idea Form
Please fill out completely
Allow 72 hours for response
Your Full Name
Company Name, if applicable
Street Address
City, State, Zip
E-mail address
Telephone Number
Full Birthdate - required
Which Package would you like?
Package 1 - Bronze
Package 2 - Silver
Package 3 - Gold
Package 4 - Deluxe
Will you be purchasing your own Yahoo GeoCities domain?
Yes
no
If yes, please do that now and put your URL and yahoo id and password here
What title would you like your website to have?
Check all of the free Options you would like for your site:
What information would you like included in your package?
Please go to my Fonts sample and choose a font for the
headings & text on your pages:
Do you have a theme in mind for your website?
Yes
no
If yes, what is it?
What type of look are you trying to achieve with your website?
choose one or more
Have you chosen a graphic artist whose graphics
you would like to use on your pages?
I haven't decided yet
Yes, I would like to use:
What keywords would describe your website?
list up to 20 individual words, separated by commas
Additional comments or questions:
How did you find my business?
Have you read and agreed to my Terms?
Yes
No
| 
