Consulting Request Form

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Company URL (www.) *

Hosting Site (www.) *

Who owns the domain name (Example: Joe Smith)? *

Your Name *

Your Business Type (Choose One) *

Accounting/Finance Consulting Legal Marketing / Advertising OEM / Manufacturing Service (repair, installation, maintenance) Other

Preferred Contact Method (Choose One) *

Work Phone Mobile Phone Email Online Form

What type of web site would you prefer? (Choose one) *

Information Only Interactive

How often would you prefer to update information on your web site? (Choose One) *

Daily Weekly Monthly Annually As Needed Never

What type of customer does your business serve? (Choose Any) *

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What social media service does your company subscribe to? (Choose Any) *

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What DO you like about your current web site? *

What DON'T you like about your current web site? *

Is there any additional information you would like to tell us? *

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