Web Design and Hosting Order Form To understand your web design needs and to serve you better, we ask that you fill out the following form. Required fields are denoted with * Personal information * First Name  * Last Name  * Company Name  * Street Address    * City  * State / Province  * ZIP / Postal Code  * Country  Phone  Fax  * E-Mail  Web Site URL  Where did you hear about us?  Design information   Design Package: Basic Web Design Elite Web Design Flash Web Design Please Select Need Project Done By: ASAP 1 Week 2 Weeks 3 Weeks 4 Weeks * Specifically describe your field of business: The colors you would like to see in your design: To help you find better color combinations for your logo please visit our "Color Chart" The colors you do not want to see in your design: Describe some ideas you might have in mind for your web design.  You can also list some web site designs you like and may want to emulate: Who are your competitors and what do you think about their web sites? Please provide any other information that will help us create a web design for you. If you are interested in additional services, please list them below:   We will start working on your project as soon as we receive your request. We will then contact you shortly to confirm your order and to answer any of your questions.     If you have any questions regarding your order and pricing, please feel free to  contact us.  We will be glad to help you.