Estimate | Belstar Media, Inc.

Contact Name:*

First Last

Company Name:*

Address:*

Street Address City State / Province / Region ZIP / Postal Code

Phone:*

Fax:

Email:*

Website (if redesign):

Please select one that best describes you:*

Check any that you want or need:*

Please select the "look-and-feel" for the website:*

Approximate number of pages to be created:*

We will maintain your website:*

Goals for website:*

Desired time frame:*

Budget for the project:*

Where heard about us:*

Describe industry:

List competitors:

Desired addresses: (yourbusiness.com)

What are your products or services:

What type of visitors would you like to draw to the site:

Describe any preparations that have already been made for the web site:

Describe any specific logos, artwork, fonts, etc. that you would like used:

List any desired characteristics for the web site (color, user interface, page layout, navigation, size of site, etc.):

List main areas of the website (services, about us, links, etc.):

How much site maintenance will be required and how often (when will page content change and what will change):

Describe the long-term plans for the web site:

Additional comments or questions:

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