Website Development Questions

Please answer the following, and provide as much information as possible.

Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone Phone - ### - ### ####
Address / Domain of Website (new or existing)
This is a . . .

This is a . . . New Site Existing Site

If the website is going to be new, client understands that there may need to be variations on the domain name based on current availability.
Purpose of Site (Check all that apply)

Purpose of Site (Check all that apply) Personal Use Business Use Online Store Gaming Portfolio Other Other
Site Name / Business Name (optional)

If this is for a business, type your company name. Otherwise, you can just choose a random name or leave it blank. We can usually figure out the site name from the domain name.
Approximate Number of Sections
Special Features/Other Instructions

Example: e-mail contact form, message board/forum, shopping cart/e-commerce
Proposed or Allotted Budget $ Dollars . Cents
Other Comments
Do you already have some experience with web design and simply want a hosting platform?

Do you already have some experience with web design and simply want a hosting platform? Yes, send me information on your paid "D.I.Y." option I want a FREE basic hosting service.

See https://ruggieroav.com/diyhosting for details.
Click the CHOOSE/SELECT FILE button to send existing logos, required text, or other materials. These will be forwarded to the team who may eventually design or re-design your site, and will be kept in the strictest confidence. See below for final confirmation.

Attach Files
By checking this box, I agree to have Ruggiero AV Services and partners review my preliminary website requirements.

By checking this box, I agree to have Ruggiero AV Services and partners review my preliminary website requirements. I agree

This is not a contract or quote. Once created, you will be required to sign it and either fax or email it to the party designing your site.