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Client Service Contract Form

Please fill out the form below and indicate whether you want a quote or directly hire to initiate work on your existing or proposed site.

First name
Last name
E-mail address
Street address
US State
Zip Code
Do you own or have a working web site? yes      no
If yes, do you want a redesign? yes      no
Do you own or have a domain name for your site? yes      no
List your existing domain name if we are revising your site? (include domain extension (e.g., .com, .org, .biz, etc.))
If not, what domain name have you choosen for a new site?
Do you need a web host server? Yes     No     Not sure
Would you like a quote or initiate work? Request Quote     Request Work
Web Site Design Packages
Special requests/comments


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