Jill Schaben Designs

This form has been developed to help me obtain information from you
about the type of site that you are visualizing.

Once you have submitted this form, and I have received a deposit
from you so that I can purchase a year's worth of hosting and your
domain name, I will begin work on your site.

CONTACT INFORMATION

Name

Business

Address City, State, Zip Code

Phone Number

Email Address

DOMAIN NAME

I already have a Domain Name and it is:

If you don't already have a Domain Name purchased,
please type your first two choices below.
(Some Domain Names are off limits
because they are already in use.)

First Choice

Second Choice

PAGES

In the box below, please list the pages that you
would like to include in your web site.

SITE DESIGN

In the box below, please list any color schemes that you may
be considering, or graphic ideas that you may have.
If you know of any sites that are similar to what
you are looking for, please list those here as well.

Please give me as much directionas possible, so that
i can ensure that the site I design is exactly what you are looking for.

Do you have any logos that you would like me
to incorporate in your site?

Yes