Project Definition:
Please complete the following form to help us accurately quote your web site requirements.
* denotes required fields
Contact Name: *
Company: *
Address: *
Suburb/Town *

Postcode:
State:

Country: *

Telephone: *

Fax:
Please indicate all items required:

* What does Your Web Site want to achieve?
Information Ordering
Sales Client Contact
Other, please specify
* Do you require Restricted Areas for staff, clients, or vendors?
* What content will Your Site have?
Products Services
Prices Guarantees
Company Information Contact Information
Privacy Statement Flash Animation
Real Time Credit Card Processing Other, please specify
Where are Your Customers/Clients?
Local Area National
State International
What Web Sites do you really like?
1
2
3
What Web Sites do you really dislike?
1
2
3
* Do You require Domain Name Registration? YES
If yes,
Domain Extension?		  .com     .net   .org   .biz    .info    .tv .au 
other regional
If No, Existing Domain Name?
* Does Your Web Site require Hosting? Yes
Any other Services required?
Logo Design Calculators
Graphics Virtual Consultants
Scanning images/photos (qty) Document Typing (qty pages)
Other, (please specify)
Who will Provide Information?
Name: * Contact Phone: *
E-mail: *
Who would Breal Report to?
Name: * Contact Phone: *
E-mail: *
* Estimated Budget $
I agree the above information is true and correct. I understand this is an outline of my requirements and does not constitute an agreement to carry out any work. I agree the quote I receive as a result of submitting this form will be confidential and may not be disclosed to a third party.
* Your name