PSAB Web Design Worksheet

Company/Nunicipality
Primary Contact Name *
Primary Contact Title
Primary Contact Email *
Secondary Contact Name (if desired)
Secondary Contact Title (if desired)
How did you hear about us? *
Address *
City *
State *
Zip *
Phone
Fax
Current Website URL (if you have one)
Do you already own the domain for this project? *

Do you already own the domain for this project? Yes No
Domain Instructions

Domain Instructions I will maintain my own domain name and am requesting your name servers. I would like to transfer our current domain to your hosting service
The domain name I own and will use for this project
My domain name is registered with
The email address on the domain is
New Domain Name

If you would like us to obtain a new domain name for you, please list 3, in order of preference, with the most desirable at the top. We will try to obtain your request in the order you provided.
First New Domain Choice
Second New Domain Choice
Third New Domain Choice
Hosting Package (click here for more information) *
Describe your organization. Assume you are describing it to someone who knows nothing about your organization. Keep the description 4 sentences or less. *
This following should be a site or two on the internet that you like that we can use for ideas concerning your layout and design.
Sample Site One *
Sample Site Two
Slogan or Tag Line (Something that describes your entity in one short sentence)
Colors to use.

Please use the color chart located at netcolors.info and provide the actual number listed with the color (example: 66CC99):
Color 1
Color 2
Color 3
Color 4
Will you be providing us with a logo? *

Will you be providing us with a logo? Yes No
Will you be providing us with pictures? *

Will you be providing us with pictures? Yes No
Would you like to use an artist for your initial web design? ($125 one time additional charge. Without the artist, we will use whatever graphic material you provide and place them in a template website. One mockup design is provided without the artist. Using the artist, 3 unique web design mockups are provided. We strongly recommend the use of the artist.) *

Would you like to use an artist for your initial web design? ($125 one time additional charge. Without the artist, we will use whatever graphic material you provide and place them in a template website. One mockup design is provided without the artist. Using the artist, 3 unique web design mockups are provided. We strongly recommend the use of the artist.) Yes No
Would you like a logo designed? ($75 one time additional charge. Logo will be delivered in digital format so that it can be used in print, etc.) *

Would you like a logo designed? ($75 one time additional charge. Logo will be delivered in digital format so that it can be used in print, etc.) Yes No
Email Needed? *

Email Needed? Yes No
Type of Email?

Type of Email? New email I have email that needs transferred
I am interested in the following services:

I am interested in the following services: Seach Engine Optimization/Marketing Business Cards Explainer Videos Infographics Printed Brochures Live WordPress Training Other Other
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Comment/Message

PSAB Web Design Worksheet

PSAB Web Design Worksheet

New Domain Name

Colors to use.