Your Name (required)

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Your Current Website

Phone

Other Websites / URLs :
Please list all Websites/Domains that your company/organization has live? Including sites with a redirect.

Search Terms:
What are your 5 most important search terms?
Please list in priority order:

Industry Specific Search Terms:
Are there any industry specific search terms that a potential client/customer might search on?
Please list your 5 most important industry specific search terms in priority order:

Geographic Terms:
What are your 5 most important geographic terms?
Consider : State, counties, areas (i.e. bay area) and cities
Please list in priority order:

Services / Products:
What are your 5 most important services or products?
Please list in priority order:

Increasing Sales / Orders:
Are there any services or products, not listed above that you would like to expand?
Please list in priority order:

Website Objective(s):
What is the Objective(s) of your Website? Do you want to sell your product or service directly over the Internet? Do you want to garner leads or generate sales calls?
Is the Website’s purpose to provide customer support or information?
What should your Website do for you and your business?
Please list your Website’s Objective(s) here:

Increasing Sales / Orders:
Are there any services or products, not listed above that you would like to expand?
Please list in priority order:

Action: What Action do you want your website visitors to take?
Please check all that apply:
Request a FREE Report or other information incentive by filling out their contact information on a form and submitting it to you for future contact and data base building.Opt Into a listPlace an OrderCall YouEducate – visit specific web pagesOther*

Other

Do you have a logo?

Do you have any brochures that you would like your website to reflect?
Yes – If yes, please send an electronic versionNo

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