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First Name
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Last Name
*
E-mail
*
Phone Number
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Area Code
Phone Number
Company Name
Website Address
What are the approximate number of pages required?
*
1 - 20
20 - 50
Over 50
Do You Need a Blog
*
Yes
No
eCommerce: Do you need a shopping cart to sell products online?
*
Yes
No
3rd Party Integration: do you require any integration between your website and a 3rd party website or application(s)?
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Yes
No
SEO: Is it important for prospective customers to be able to find your website on Google?
*
Yes
No
Do you have a deadline?
Within 30 days
Within 60 days
Within 90 days
Flexible
Do you currently, or plan to use your new website for digital marketing?
Search Engine Optimization
Pay-per-click Advertising
Social Media Marketing
Inbound Marketing
Content Marketing
Reputation Management
Email Marketing
None of the above
How did you hear about us?
*
Google (or other search engine)
Personal Referral
Read one of our books
Heard on a Podcast
Read on another website
Other
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