Informate Web Design - Web Site Proposal

Name:
Company Name:
Email:
Address:
Phone No:

Type of Service:	M F
What sort of project is this?	M F
What features do you anticipate using on your site?
	Below 18 18 - 25 26 -35 36 - 45 46 - 55 Above 55
Project Details:	Tell us about your web design project. Please be very detailed so that we can provide you with an accurate quote:
Project Package:	Thinning (finer hair strands or fewer hair strands) Balding (when you're starting to see an open patch on your scalp)
When would you like the site to go live?:

Do you need web hosting?:
	Do you have FINER hair strands? Do you have FEWER hair strands?
Do you need site maintenance?
	On that open patch, do you still see fine hair growing on it? On that open patch, is it a completely bald patch?
Are you able to supply pictures and content for the site?
	1 - 2 years 2 - 4 years 4 - 6 years 6 - 8 years More than 8 years
Give URLs of any sites you like or would want to model your site after:
	URL 1:
	URL 2:
Security image:	RELOAD
Enter text you see above: