When are you needing services?

Immediately Within 2 Weeks Within 1 Month Uncertain

What type of Web Site are you Interested in getting designed?

Personal Home-Based Business Business Community, School, or Church Organization Combination

Which Web Site Design Package are you interested in?

Basic Simple Standard Advanced

What Type of Business or Organization is the Web Site For?

Who will you be directing your Web Site towards?

What will the main purpose for your Web Site?

Communicating with co-workers Communicating with friends and family Desiminating information to the public Maintaining and attracting new membership Marketing a professional service Selling a product Other

What will the secondary purpose for your Web Site?

Communicating with co-workers Communicating with friends and family Desiminating information to the public Maintaining and attracting new membership Marketing a professional service Selling a product Other

Will you be providing any graphic images or logos?

Yes No

Will you need any custom graphics or logos?

Yes No

How did you here about VIP Consulting?

The Atlanta Journal-Constitution Creative Loafing A Friend or Business Contact VIP Consulting Brochure or Phanplet Another WEB Site

Web address is http://
Other:

Tell us how to get in touch with you and what is the best time to do so?

Name     
E-mail   
Tel      
FAX       
Time      

Please contact me as soon as possible regarding this matter.