** DotCom Design Studio - Custom Websites

Step 1 of 7

Personal Information
If you are managing the development of a website on behalf of another client, please enter the end user's information below.
First Name:		Last Name:
Home Phone:		Cell Phone:
Email:

Business Information
If you are managing the development of a website on behalf of another client, please enter the end user's information below.
Business Name:
Address:		City:
State:		Zip:
Phone:		Fax:
Current Website Address:

How long have you been in business?		Existing business - in operation for: yrs We're new, planning to launch in : months.
How many full-time employees (including yourself)?
How many part-time employees?

Complete ONLY if You are a Website Re-Seller / Service Provider / Consultant
If you are managing the development of a website on behalf of another client, please provide your information below. Otherwise continue on to the next section.
First Name:		Last Name:
Home Phone:		Cell Phone:
Email:

Business Name:
Address:		City:
State:		Zip:
Phone:		Fax:

		Continue to Step 2 of 7