Website Questionnaire

This information will only be used by San Diego Internet Services
to respond to your request for information or to help design your website. 

This information is kept strictly confidential and will not be sold or distributed
to any other entity without the our client's permission.

 
Required Fields  * Form will not complete unless correctly filled in.
Name:*  Required
Phone:*  Required
Email:*  Required
Address:
Suite/Apt:
City:
State/Province:
Zip Code:
Country:
Fax Number:
URL:
   
Where did you hear about  San Diego Internet Services?

For multiple choices, press and hold the Ctrl Key while making selections

Some information we would like to know before we respond with a reply.

I need my existing website redesigned
I need a completely new website created
I need advertising & marketing advice for my website

Do you have text that can be used for your website? Yes No
Do you have graphics or pictures?
Yes No
Do you wish to have post-website training to maintain your site yourself?
Yes No

Will you be selling a product or products on your website? Yes No
Describe your products.

Will you be selling a Service on your website? Yes No
Describe your services.

Do you wish to take credit card orders on-line? Yes No

Do you have a merchant's account to process credit cards? Yes No

What is the name of your Internet Services Provider?

How soon will you be ready to start?
 

Please contact me by E-mail Reply.
Please contact me by telephone.

What is the best time to call you? Morning Afternoon Evening

If you have any further comments or questions please be specific and enter your questions or requests in the space provided below.

Thank you for submitting the information, we will reply as soon as possible by the method you selected as your preference.

Please

Enter the code as it is shown:

the Information (Reset Form)