Web Design Quote Request Form

Blais Web Creations: Fill Out Our Quote Form for a free quote.

 Please take the time to fill out this form to help us better serve you. Give us an idea of what you are looking for, so
 that we can give you a quote. We will contact you to discuss your needs further. Please no adult oriented sites.

Contact Information

Business Name:  
Address 1:  
Address 2:  
Zip Code:  
Do You Have A Web Site Now?    Yes or No
If So, Would You Like Us To Refresh It?    Yes or No
Current Home Page:  

Web Package Pages
(Pages Average $100.00 and up.)
Reminder: Home Page is One page for the introduction of your business

 About how many pages do you have in mind, including your Home page?

 Select any additional page options that you might want in your web package

 E-Mail/Contact Page
 Questionnaire Form (like this one)
 Guest Book
 Feedback Form
Links Page
 FAQ Page
 Data Access Form ($500 & up. Requires Database)

 Other Items you might want to add to your site:
Directions Map - A graphical map of your area
 Images or Scan Photos (various formats available)
 Multimedia effects
 Java Script-Scrolling Text
 Print and Mail-in Form
 Music/Sound Files

 Will You Need To Have Your Site Maintained (regular changes/additions)?
 Yes or No

 If Yes, how often? 
 Monthly Quarterly Yearly On Request

 Would You Like Us To Host Your Site?
 Yes or No

 What domain name would you like to reserve?

 Please describe your business and what your site would be about?

 Do you have any other comments?

 How did you find us? (Very Important To Us!)


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Copyright 2014 HI-Tech Software
Last updated: 01/03/2014

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