WestPage Publishing     Home Website Design and Hosting
Website Questionnaire
This attaches to Website Agreement, and provides details for web design.   View form in Adobe Acrobat Reader
Owner Name
Business Name
Physical Address
City	StateZip
Mailing Address
City	StateZip
Local Phone (with area code)
Toll Free Phone
Local Fax    (with area code)
Toll Free Fax
Email Address
Domain Name Already Owned:
Domain 1st Choice
Domain 2nd Choice
Products in Order of Importance
1
2
3
4
5
Services in order of importance
1
2
3
4
5
Manufacturers Represented
Mfr1   / Website
Mfr2   / Website
Mfr3   / Website
Mfr4   / Website
Slogans
Credit Cards Taken	Visa      M/C     Discover      Amex
Do you finance?	Yes                         No
Weekday Hours
Saturday/Sunday Hrs
A website You like:
Why liked:
Colors Preferred
Special Instructions
Should materials be returned?	Yes                  No
I am sending:	Logo	Letterhead	Business Card
	Photos	Artwork	Brochure
	Yellow Page Ad	Other Ads	Forms
	Resume	Catalogue	Product Instruct
	Other

You may also print out and fax to 1-866-459-1139
                               or mail to PO Box 692, Rochester, WA 98579