*Red Dot Creative Media*

First and Last Name
Company Name
Mailing Address
City
State
Zip
Contact Phone
Email Address
Confirm Email
Package
If other, please describe:
Do you own a domain name (www.domainname.com)?
If not, what is your first choice domain name?
Second Domain Name
Third Domain Name
Please check all that apply	.com .net .org .biz .us
Do you have a hosting company?
Hosting Company Name
Hosting Plan
Do you have a logo?
What are the colors of the logo?
Please describe how you envision your site and what function you’d like it to perform
Please select the colors that most appeal to you for incorporation on your site: (see color chart below)	Color 1 Color 2 Color 3 Color 4 Color 5

Please check the style that best describes your website (check all that apply)	Modern Hi-Tech Classic Clean Fun Business Busy Basic Other
How many pages do you want on your website?
Please select the appropriate page names for your site (check all that apply)	Home About Contact Us Email Articles Links Information More News Press Events Partners Sponsors Schedule Mailing List Other 1 Other 2 Other 3 Other 4 Other 5 Other 6
Please enter your favorite three website urls (design):
What is the action item of your website?	To view work To contact me To hire me To sell products Informational To share images Online Resume To gather Mailing List To Join Membership (other)
Do you have a tag line or mission statement?
Please supply your tag line and/or mission statement
What type of payment will you be using for services?
After submission you will be contacted by Red Dot Media Creative for a phone consultation within 24 hours.

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