Custom Web Site Design and Development Order Form
Fields Marked with an * are required
*
Theme of Your Site:
Business Site
Personal Site
*
Your Complete Name:
*
Company Name:
(Please Type N/A For Personal Site)
*
Email Address:
*
Mailing Address:
*
City:
*
Province:
Zip:
*
Landline Phone Number:
(with area code)
*
Mobile Phone Number:
(with mobile code)
*
Do You Require Customized Logos/Graphics?
Yes
No
*
Your Preferred Link Format:
Plain Text
Plain Image
Dynamic Text or Image Link
Combination of the Above
*
Are Your Images Web Ready?
(Already Scanned and Stored on Disk)
Yes
No
*
Will You Be Using Web Scripts?
(CGI, PHP, JavaScripts)
Yes
No
Do You Want Us to Install/Configure
Your Scripts for You?
Yes
No
If Yes, How Many Scripts Will You Be Using On Your Site?
1
2
3
More Than 3
*
Would You Like to
Host Your Site at Hosting.ph?
Yes
No
Additional Instructions
/Requirements:
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