Pettit Media, LLC



	Purpose of web site:	Personal Business

	Contact Information

	First Name:
	Last Name:
	Title:
	Company Name:
	Address:
	City:
	State:
	Zip Code:
	E-mail Address:
	Phone:

	Domain Registration & Hosting

	Do you need a domain name (i.e. www.yoursite.com) registered?	Yes No Don't Know

	Is this a new web site or a redesign of an existing site?	New Redesign

	Current Domain Name (URL):

	Do you want hosting set up for you?	Yes No Don't Know

	Web Site Look & Feel

	It is important to us to understand what you want your web site to look like. Provide a few examples of web sites you like. Type in the URLs (i.e. www.yahoo.com) to these web sites:

	Web Site # 1
	Web Site # 2
	Web Site # 3

	What do you like about the sites you listed?

	What do you NOT want on your site?

	Web Site Content

	Will you write the text or will we write it?	I Write It You Write It

	Do you have any graphics, photos, music, video clips, or other media that you want to include in the site?	Yes No

	Budget Information

	What is your budget?	$500 to $1000 $1000 to $3000 $3000 to $5000 $5000 to $10,000 $10,000 to $20,000 $20,000 to $50,000 Greater than $50,000

	When do you want the site completed?	Month Day Year

	Additional Services Required (Optional)

	Please select the other features, functionality, and services that your site will require.	Shopping Cart Audio/Video Streaming Database Content Mailing List Search Engine Photo Album Calendar Blog Wiki

	Questions or other information we may need:

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