Work Request

Please complete the following questions, so we can understand your needs and schedule your work.

Are you a new client?

Yes
No

CONTACT INFORMATION

Please provide your contact information.

Name*

Prefix First Last Suffix

Company or Organization Name*

Please enter your company, non-profit or organization name.

Email Address*

Enter Email Confirm Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Website Address*

REQUESTS:

Request Type*

What do you need help with? Please check below:

Technical Assistance
Maintenance
Minor Change
Major Change
Re-design
New web site
Other, Please define below

Technical Assistance Detail*

Briefly describe the issues with your web site. Please be specific and include error messages, page names, sections, etc.

Maintenance Detail*

Briefly describe the small change you need. e.g. " Add an event to my calendar, Update a team member, Change a menu, etc."

Minor Change*

Please select the type of small change your web site needs:

Major Change*

Please select the large change your web site needs

Re-design*

Please select the type of re-design your site needs. You will be directed to another form for more details.

Describe Design Modifications:*

Briefly describe why you want to change your web site.

Any major functional or visual changes require additional details from you, extra analysis and time from us. You can assist us in understanding your needs , by completing the next form. Please click here to request a new web site or redesign.

LINKS

Number of Links*

How many links need to be changed? You can specify up to 5 links.

Please enter a number from 1 to 5.

Link Change 1:

Please select an option. You will be prompted for up to 5 pages/links.

Add a link
Change a link
Delete a link

Page Name 1:*

Please provide the page name where the link should be added, changed or deleted.

Link TEXT 1*

Please tell us what text should be highlighted for this link.

Link / Web Address 1*

Please give us the external web address or page name that this page should link to.

Examples: For external sites: list the web address: "http://www.example.com/page". For your site, list the page name, "Home" "Contact Us"

IMAGES:

Note: We can help edit and size your images, at an additional charge. Just let us know what you need.

How many images do you want to add?*

Please complete the following fields for EACH image. If you have more than 5 images to add, please email them to us and include the page name and location where images should be placed.

Please enter a number from 1 to 5.

Page Name 1:*

Please provide the page name where this image should be added:

Image 1 Placement*

Please indicate where the image should be placed on the page.

Upload Image 1*

Please upload image 1

Max. file size: 256 MB.

Page Name 2:*

Please provide the page name where this image should be added:

Image 2 Placement*

Please indicate where the image should be placed on the page.

Upload Image 2*

Please upload image 2

Max. file size: 256 MB.

Page Name 3:*

Please provide the page name where this image should be added:

Image 3 Placement*

Please indicate where the image should be placed on the page.

Upload Image 3*

Please upload image 3

Max. file size: 256 MB.

Page Name 4:*

Please provide the page name where this image should be added:

Image 4 Placement*

Please indicate where the image should be placed on the page.

Upload Image 4*

Please upload image 4

Max. file size: 256 MB.

Page Name 5:*

Please provide the page name where this image should be added:

Image 5 Placement*

Please indicate where the image should be placed on the page.

Upload Image 5*

Please upload image 5

Max. file size: 256 MB.

Image File Upload

You can upload up to 10 images in jpg or png format.

Please rename your images so we can easily identify them.
Example: An image named img001.jpg doesn't help us, when we're trying to place it on a page, but we can identify an image of daisies, called daisies.jpg

Drop files here or

Accepted file types: jpg, png, Max. file size: 256 MB, Max. files: 10.

CONTENT CHANGES:

How many pages do you need to add or change?*

Please enter a number from 1 to 10.

Note: We provide Writing Services to copy write or edit page content by the hour.

Page Name 1:*

Please list the page name you want changed or added.

Content Upload Files*

You can upload up to 10 files in doc, docx, PDF or txt format.

Please provide meaningful names that match your PAGE NAME.

For content changes, it makes our life so much easier, if you can highlight the changed text.

Drop files here or

Accepted file types: doc, docx, pdf, txt, Max. file size: 256 MB, Max. files: 10.

How many pages will have images?*

PDF Documents

How many PDF documents?*

Please enter a number from 1 to 10.

Are your documents in PDF format?*

Downloadable documents should be in PDF format so visitors can read them on any computer, tablet or mobile device.

My documents need to be converted to PDF format
ALL my documents are in PDF format

Note: We can convert your documents to PDF format starting at $5 per document

How many documents need to be converted to PDF format?*

PDF Page Name 1

Identify Page where PDF should be attached.

Upload PDF Files

You can upload up to 10 files. Please provide meaningful names so we can easily identify the files.

Drop files here or

Accepted file types: pdf, doc, docs, Max. file size: 256 MB, Max. files: 10.

ADDITIONAL FEATURES & FUNCTIONS

BLOGS

Do you want to add your blog to your main menu?*

Yes
No

Blog Name*

What is your blog's name? This is the name that will appear on the menu, the top of the Blog page, Links on your web sites, etc. Examples: "Blog, My Writings, Daily Inspirations"

Do you want to automatically send new blog posts and/or newsletters to your subscribers?*

Yes
No

Do you have an account with a Mailing List Service?*

(examples: Mailchimp, aWeber, Get Response do; Constant Contact doesn't)

Yes
No
I have one but I don't know
Please make a recommendation

Do you need assistance creating an email template?*

Templates can be created to coordinate with your web site's design using the logo, header image, colors, etc.

Yes
No thanks, I'll do it myself

SOCIAL MEDIA

Check any of your Social Media Account Links you want to appear on the site*

Please check all that apply

Facebook
Twitter
LinkedIn
YouTube
Pinterest
Tumblr
Other (Please Define)
NO Social Media

Provide your Facebook Link:

Provide your Twitter Link:

Provide your LinkedIn Link:

Provide your YouTube Link:

Provide your Pinterest Link:

Provide your Tumblr Link:

Identify Other Social Media Sites*

Do you want visitors to be able to share your web site on THEIR social media accounts, to increase your site's reach?*

Yes
No

FORMS

Do you need a custom form?*

Please check all that apply

Contact Form
Subscribe to my Mailing List
Payment/Subscription
Donation
Event Registrations
Intake Forms
Online Survey or Questionnaire
Other - Please define below

How many Custom Forms will you need?*

Custom Form 1*

Please define custom form 1

Custom Form 2*

Please define custom form 2

Custom Form 3*

Please define custom form 3

SELLING PRODUCTS or SERVICES

Are all payments in US $ currency?*

Yes
No

How will you accept payments?*

Link to Paypal
Order Form that links to Paypal
Payment Form that links to Paypal
Link to an external shopping cart site
I need a shopping cart
I don't know. Please make recommendations

NEW FUNCTIONS

Select additional features you think you want to add:*

Check all that apply

Google Map
Upcoming Events/Calendar
Password protected pages or area in your site
Nothing extra thanks
Other (Please define below)

Define Additional features you need?

SCHEDULING and OTHER BUSINESS STUFF

Date Needed*

Please select one of the following options:

We are always juggling many projects. We do our best to accommodate clients' needs.

Emergency (24-48 hours)
ASAP, but I'm in no rush
Whenever you can fit me into your schedule
I need it by (specify date below)
I'm just starting to think about this

Desired Delivery Date

We are always juggling many projects. We strive to meet your scheduling needs, but unfortunately, we can't always guarantee it..

Do you have a maintenance agreement with us?

Yes
No

Note: Clients with maintenance agreements are charged a discounted rate against the balance in their accounts. Hours exceeding the balance, will be charged at our usual rate.

We strive to provide turnaround ASAP, but we cannot guarantee 24/7 support or immediate scheduling.

Do you have a promotion code?*

We often give discounts, please enter your promotion code below:

Yes
No

Promotion Code

What else do we need to know? Any needs not covered in this questionnaire?

CONTACT INFORMATION

REQUESTS:

LINKS

IMAGES:

CONTENT CHANGES:

PDF Documents

ADDITIONAL FEATURES & FUNCTIONS

BLOGS

SOCIAL MEDIA

FORMS

SELLING PRODUCTS or SERVICES

NEW FUNCTIONS

SCHEDULING and OTHER BUSINESS STUFF

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