Please fill in a valid value for all required fields
Are you sure you want to leave this form and resume later?
You must upload one of the following file types for the selected field:
There was an error displaying the form. Please copy and paste the embed code again.
Apply Discount
You saved
with code
Phone: 866-511-ADLC
Fax: 770-452-3641
support@adlcllc.com
www.adlcllc.com
Interview for Web Development
Date
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2012
Company Contact Information:
Customer Name
*
First Name
Last Name
Address
*
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Cell Phone
Email
*
Work Phone
Signed By:
*
Please describe your organization in a few sentences.
Is your business local or nationwide?
Where do most of your customers come from?
Can you provide me with electronic (preferred) or hard copies of company brochures, business cards, letterhead, logo's etc., for use on the website?
What type of advertising do you currently do?
Newspaper
Radio
TV
Internet
Billboards
Direct Mail
Coupon Books
Other:
Other Value
Do you have a current web site?
What do you like most about your website?
What do you like least about your website?
Do you own a domain name and have access to it?
Would you like your customers to contact you via the net?
Are you planning to do online sales? If so, what is the product, and how many items do you want to sell online?
If you’re planning to sell online, are you set up to accept credit cards?
select
Yes
No
Do you maintain a mailing list on your site?
What forms of Payment do you accept for your services?
Visa
Mastercard
American Express
Discover
Cash
PayPal
Money Orders
Financing Available
Other:
Other Value
Who is your target audience?
Do you have a main color in mind? Is there a color I should stay away from when building your site?
If not, is there a color I should stay away from when building your site?
If you were using a search engine, what words or phrases would you use to find your site? Which of these words or phrases is most important? Second? Third?
What do you want to be the main focus of your web site?
How do you plan to get the word out on your new site?
Will it be listed on your business cards, letterhead etc.?
What kind of deadline are you working on for your new site?
Who are the decision makers on this project? What is the turnaround time for making a decision?
How many pages do you think your web site should be starting with HOME, ABOUT US, and CONTACT etc?
Do you have or maintain a database? If so, what do you require?
Have you researched your online competition so you have an idea of what you do and don’t want on your site?
Please list the names of five other sites that you like. Why are they attractive to you?
What is your deadline for completing the site?
What is your budget for this project?
Atwork Upload
Company logo, pictures or other Artwork for design
Use this form to attach your artwork.