• ADMINISTRATION / SETUP

•  

• Referred By:   (Provide Affiliate's Full Name or Nickname)

•  

• Website SETUP for:*

•  

• Phone*

•  
• Company/Ministry/Organization Name*
•  
• Email Address*
   
• Name of contact person to coordinate items required for website*
   
• Tel*   Cell   
   
  Email*
   
  Fax Number:  (Fax is required to send/receive contracts)

• What do you want your website to be called? (ie. www.mywebsite.com)*
  www.or www.
•  
• Do you already have a Logo or Existing Graphics:
  Yes, I have existing graphics
  Yes, I have a logo
• Yes, I have logo and existing graphics
  No, I would like to have a logo designed at additional cost
  
•  
• On-time completion of site is dependent on timely submission of requirements.
•  
• How soon do you need the website up and running? ----- please select one ----- 3-5 Business Days (a $200 rush fee will be added) 10-12 Business Days 13-19 Business Days 20 days or more
•  
• How long do you want to PRE-PAY to OWN your website name? ----- please select one ----- 1 year-$19.95/year 2 years-$14.95/year (save 25%) 5 years-$11.95/year (save 50%) 10 years-$9.95/year (save 75%)
•  
• If you have a DOMAIN COMPANY & HOST SERVER, please provide their name below. If not please leave it blank.
  
  I have an existing username/password for this domain/host server.
   NOTE: If you selected “Yes” to #5, further review of the host server company’s information is NECESSARY prior to website design acceptance.
•  
• DESIGN QUESTIONS
•  
• Select the type of DESIGN you want?
   
  Professional Template-Based Design, custom branded with my own graphics & logo (price range: $395+)
  Create a CUSTOM DESIGN totally from scratch (price range: $750+)
  Social Networking Online Community (price range: $1,250+)
• Do you want any music, voice or video MEDIA on your website? *
• 
  Music
  Voice
  Music & Voice
• Music, Voice & Video Clips ~ How many videos do you have?      How long are they? (seconds)
• No, I don't want media
  
•  
• What color scheme? (Click the links below to GET the NUMBER of your color choice, then TYPE it below)
• 
  MAIN Color: (Click here to GET the number of the  MAIN COLOR of your website design)
• 
  SECONDARY Color: (Click here to GET the number of the SECONDARY color of your design)
  
•  
• BUSINESSES: What services do you want to emphasize on your site? Identify what your site is all about in the box below. Don’t let anyone wonder what you do or what you sell.
  

What DATA or information do you want to COLLECT from your visitors?

•  
• Will you be SELLING any products / services?
  Yes (A Paypal Application will be required to be submitted.)
  No
  
•  
• Will you have a photo gallery? Please check the appropriate box below.
  No Photos
  1-20
  21-40
  41-80
  81-200
  201+
  
•  
• Privacy Policy:
   
• If you collect any information from your users, do you have a clearly written Privacy Policy already composed?
  Yes
  No
  
•  
• Sign Up:
   
• Do you plan to solicit user e-mail addresses for a newsletter or other communication from your website.
  Yes
  No
  
•  
• Do you want FLASH HEADER (Animated Design)
  Yes
  No
  
•  
• Check all pages you want to include in your website:
  Home Page
  Contact Information
  List of Products (shopping cart)
  Special Events
  About Us
  List of information (ministries, clients, etc)
  Audio download page
  Services provided
  Schedule for office hours, events (daily, weekly, monthly, yearly)
  Biography
• Mission / Vision
  Guestbook Page
  Portfolio
  Members / List of Staff
  Others:
  

ADVERTISING/MARKETING

• Do you have WANT to ADVERTISE your website and/or services. Check the methods you want.
  Radio Station ($50 monthly subscription required with at least 3 months paid already)
  Telephone Voice Broadcasting ($50 per 100 calls)
  Individual Email Advertising ($100)
• Individual Email Advertising with audio ($125)
• Individual Email Advertising with video ($150)
  Newsletter Email Advertising (included in $30 / $50 monthly subscription)
  Internet Radio ($150) – up to 10 mentions & interview
  
  

TRAINING / MAINTENANCE (After the website is completed)

• Do You Plan to MAINTAIN your website yourself (Monthly Updates, etc.)
• Yes, but training is NOT needed
  Yes, and training is needed
• No, I would like for your company to maintain our website and do edits/updates at additional monthly cost
•  

• TRAVEL

• Do you currently utilize an online travel portal site (ie. Travelocity, Orbitz, Cheap tickets)?
  Yes, a travel portal is not needed
  No, I’d like more information on owning my own travel portal for my business at approx. $50 per month
• No, and I don’t want my business/church/organization to own its own travel portal

        LEGAL

•  
• Do you currently utilize a form of legal service for your business/ministry/organization?
  Yes, we already have legal protection for our business/ministry/organization
  No, I’d like more information on Pre-Paid Legal services starting at approximately $20-40 per month
  No, and I don’t want my business/church/organization to be protected legally