Step 2: Final Step
Website Design Questionnaire

You're just one step away from starting your new website with me!

Please fill out the form below to complete your request for one of my Website Design packages. Please be very thorough when answering these questions so I can get a scope on what you like in terms of design for your website.

If you would like to complete this at a later time, simply bookmark this page and come back.

Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-mail Address*
Street Address*
Zip/Postal Code*
Business Phone*
Business Name*
Which Website Design Package did you purchase?*
Want to add-on to the package? Request a special quote here for photo galleries, additional pages, forms, shopping cart, etc. (Extra fees may apply)
What is your industry?*
What does your business do?*
What sets you apart from your competitors?*
Do you currently own a website or domain name? If yes, please give the URL. If no, please suggest a desired URL.*
What words best describe how you want your business and website to be percieved?*
ExpensiveFamily OrientedFeminine
MasculineModernMouth Watering
What colors do you want to see in your website design?*
What website design styles do you like?*
For inspirational purposes, please provide URLs of websites you find appealing.
Additional Comments or Questions
How did you find out about me?*
Search Engine (Google, Yahoo, Bing, etc.)
Advertising (Flyer, Postcard, Web Ad, etc.)
Social Media (Facebook, Twitter, LinkedIn, etc.)
Referral or Friend
By checking the box below, you verify that you have read and agree to my terms and conditions.*
I have read and agree to the terms and conditions of Graphically Innovative Designs.

Please enter the word that you see below.


Privacy Policy: I hate spam just as much as you do. I will not give or sell any of your information to other parties, it will only be used to enable me to reply to your request.

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