Affordable Web Design, eMobile Me, ePrivate Schools, Steamboat Hosting & Telluride Websmith are divisions of Hammerweb Holdings, LLC

Contact Information
* indicates required

Name (first and last): *
Company: *

Street Address: *
  City, State & Zip: *
Phone: *
  Mobile Phone:
Email Address: *
  Website URL: (if new site with no URL yet, indicate desire URL) *

Purpose and Goals for the New Website

What is the Primary Goal for the new website?
What geographic areas would you like the website to appeal to (check all that apply)?
Local Regional National International
Who do you want to reach (be specific; ie: age range, professionals, interests):
The new website should (check all that apply:
Sell Products Capture Newsletter Signups
Sell Memberships/Subscriptions Archive Articles
Collect Online Donations Host a Catalog, Price List or Portfolio
Event/Seminar Registration Provide Information
Generate Leads Customer Technical Support
Communicate Benefits Offer Download Music/Software
Entertain Other (please specify below)

Domain Names and Hosting

Do you have a domain name registered? Yes No
If yes to above, what is domain and where is domain registered?
Do you have an existing committment to a web hosting company? Yes No
If yes to above, are you wlling to move your website to one of our dedicated web servers? Yes No

Text and Graphical Content

Have you considered your navigation structure (top level and sub pages)? Yes No
If so, please indicate below:

Approximate number of pages that will be on your website initially:
Will your new website be using content from an existing website? Yes No
Will you be writing new copy for the new site? Yes No

If yes to above, please select one choice below:
Copy is complete Copy is in progress I have not started writing the copy I am interested in working with a professional copywriter

Design Style and Branding

How should your audience perceive your business when they visit your website (select all that apply):
New, Ground Breaking Wildly Creative, Exciting
Complex, Intricate Helpful, How-to
Earthy, Warm Subtle, Understated
Personal, Handmade Exclusive
Innovative An Industry Bible
Established, Has Longevity Authoritative Resource
Conservative Simple, Bold
Informal, Breezy Retro
High Tech, Cool Agressive
Reliable Reference Cutting Edge
Do you have a logo that you would like to use on your website? Yes No
If no to above, are you interested in having us create a logo for you? Yes No
Please describe any other images/graphics that you would like to have included on your new website:
Please indicate three websites (please provide website address) you like and what you like about these three websites:
1. What you like:
2. What you like:
3. What you like:
Please indicate three websites (please provide website address) which you consider to be your competition:


Please indicate any other features in which you are interested in adding now or in a future phase (check all that apply):
Site Search
Online Registration with data writing to an online database
Online Registration with data emailed to administrator
Survey, Voting, Polling Tools
Email Newsletters
Ecommerce Shopping Tool
Ecommerce Shopping with Credit Card Processing
Social Networking (Facebook and Twitter)
Password Protected Area
Site Translations to Other Languages
Online Booking/Reservation System
Banner Advertising
Event Calendar
Document Management
image/Multimedia and Photo Galleries
Search Engine Optimization
Text Messaging
Mobile Website Display
Mobile App
Mobile Shopping Cart

Shopping Cart
(complete this section only if you are considering adding a shopping cart to your website)

How many initial products to you plan to include in your online store?
How many images do you want to display per product?
Do you want to have? Real-time credit card processing at time of online order Desktop credit card processing after order is placed online

Content Management

Do you want to have a CMS (Content Management Solution) included on your website allowing you to manage and edit the content on your website?
Yes No

Time Frame & Budget

What is the ideal target launch date for your new website?
Please provide a budget for you new website - If this is difficult to do, please simply provide a high and low number:

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Hammerweb Holdings LLC: 2244 Faraday Avenue, Suite 142, Carlsbad, CA 92008 - 866.892.6822