Please use this form to
request a quote for professional website design. Contact information required for a
response.
1. Personal Contact Information:
*First Name:
*Last Name:
*Phone:
Fax:
*Email:
2. Company Information:
Company Name (if applicable):
*Website Address: www.
.com
.net
.biz
.org
.info
other
*Hosting Company:
*Do you need a personalized
"Under Construction" page, which would be seen by visitors until your
website development is complete?
Yes
No
3. Website Purpose and
Expectations:
*Which of the following segments
closely describes your website category:
Brochure/Catalog
Sales - Service
Church/Non Profit
Social Networking
News/Information/Blog
Temporary Site (Special
Event/Short Term or Seasonal purpose)
Sales - Product
Other
*Please briefly explain the
purpose of your website (200 words max).
Characters Left
*
Once your website is published, what changes do you
expect in your business/venture:
Will you accept payments on line?:
Yes
No
*Approximately how many of the following
categories do you expect your website to have. If none, please
input a zero:
Estimated Site Elements
Pages
Images (photos, logos, product images, etc.)
Downloadable Attachments
Online Forms for customer completion
4. Quote Delivery Preference:
Quote Delivery. What is your preferred method for
receiving your quote?
Phone
Email
Fax
Please verify the accuracy of Contact Information for quote
delivery.
5.
Hillman B2 Policies
Payment & Cancellation. All Quote
Requests submitted through this website are submitted with no
purchase obligation. In order to receive services, HillmanB2.com
website visitors must agree that after receiving a quote, if a
product or service is then ordered, that full compliance with the
terms of our Payment & Cancellation Policy is required. The
policy can be reviewed
here.
6.
Waiver & Form Submission
Agreement with the Hillman B2 Policies is required to process the
form. If you do not agree, you may close out this window.
If you agree, proceed forward by selecting the I agree option below:
I
agree
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