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This seems like an extensive form but it will help us understand what your requirements might be.  Please tell zzzWeb as much as you can so that when we call on you we will be as prepared as possible.

 

Company Name:
Address1:
Address 2:

City:      State: 
ZIP Code:    Country:  

Person to Contact:
Title:
Email Address: 


Telephone:    EXT:     FAX: 

Company Web URL: 

What is your vertical Industry segment or focus

Describe your Business and your Areas of Specialty 

Describe what your expectations are for zzzWeb:

Please check your area of Web Site Design interest (All that apply).

zzzWeb Presence Package
zzzWeb Expanded Package
zzzWeb Standard Package
Custom Quoted Package
Text creation
Shopping Carts
Secure Commerce and Credit Card Processing
Frames
Forms
Shockwace Movies
Technical Writing / Training
Java
Custom Databases
Net Objects Fusion
Macromedia Dreamweaver
FrontPage 97, 98 and 2000
HTMLOS
Macromedia Director
Macromedia Flash
Custom Graphics and Logos
Audio
Video
Voice Communication
Other Explain Below

       

Number of Employees in your company: 

Do youalready have a Internet presence?