Name
*
First Name
Last Name
Preferred Name (if applicable)
My pronouns are:
Select all that apply.
If you selected "Other" in the section above, you are welcome to indicate your pronouns below.
Email
*
Mobile Phone
*
(###)
###
####
Business Name
*
Business City & State
*
Ideally, I would like to have my service(s) completed by:
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MM
DD
YYYY
My business' target audience age group(s) is:
*
Select all that apply.
My business most accurately fits into the following industry/industries:
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Please select only one OR two that apply best.
I am interested in the following services, where possible:
*
Select all that apply.
I want my site to be/have:
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Select all that apply. For reference, "responsive" is a term used to describe a site that has been specifically designed to be compatible with the associated device/screen.
If you selected "Other" in the section above, please briefly describe what feature not listed that you would like included on your website. Links to another website to give a visual example are welcome.
If you are interested in Website Design or Website Re-design services, you are welcome to include links to websites you like below. With each URL, please include what you like about that site ("everything" is an acceptable explanation).
Please separate URLs (alongside their accompanying explanations) with a comma.
If there are any details you feel are relevant to the creation of your custom quote or if an answer to one of these questions was not an option, please provide that information below.
I understand that, by submitting this form, my information will be used to build a personalized quote and service package tailored to my needs. My information will be kept private and never be shared with any third party person or entity.
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I understand that receiving a personalized quote is not a guarantee of service; a contract between myself and Lou Relayson must be signed to secure his service(s). I understand that I am not obligated to hire Lou after receiving my quote.
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