Website/E-commerce Response Form
Please provide us the following information. It will help us to serve you better
1. Primary Information
Company Name
Nature of Business
No. of Employees
Address
Tel No.
Fax
E-mail Address
2. Contact Details
Contact Person Name
Designation
3. Existing System
Current System Supplied By
7inone
Other
Specify
Current Operating System
Dos
Win
Unix
Other
No. Of Users
Networking Available
Yes
No
Maintenance of the system is carried out by
In house-staff
Supplier
Other
Specify
Notes
4. New Website
Are you looking for a
New Website
Re-design
if you are requesting Re-design of an existing site. Please give us the URL below
5. Domain Name
Do you have domain name
Yes
Specify
No
(If No) would you like us to register a domain name for your company?
Yes
Please, list
1. First Choice
2. Second Choice
3. Third Choice
6. Please Help Us To Understand The Purpose/s Of The Website
General Commercial
Online Brochure
Educational
Online Exhibit
Community Forum
Online Catalogs
Non-Profit
To Promote
Generate Awareness
Advertize Price List
To Sell P/S
Other
Specify
Briefly describe the objective of your website
7. Which Service Are You Looking For
Web Design
Online Shopping
Consulting
Hosting
E-commerce
Other(Specify)
8. E-Commerce
Do you have database
Yes
(If Yes) Specify
No
9. Website Features
Would you like your Website to be based on
Text
Pictures
Text & Pictures
Animation
3D
Flash
Counter
Scroll Text
Frames
Banner
Specify other
10. When Do You Need Your Website To Be Online
Within 8 weeks
Within 8-12 weeks
Within 12 weeks - plus
Customization requirements
Any other requirements
11. Please Specify
Do you want us to organize a demonstration at our office
Yes
No
Do you want someone to vistit your company
Yes
No
Do you want us to send a quotation
Yes
No
Date
Filled By