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Web Intake Form

NEW WEBSITE INTAKE FORM

This form will help us put together a solution that best reflects you or your business. What you say here will determine how much work needs to be done and will save you time and money by identifying your specific project requirements. Please fill in with as much detail as possible.

Name *

First

Last

Email *

Company Name *

Cell Phone # *

Used for Internal office use only, not to be placed on website.

Additional Phone # *

Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Address to be listed on website, leave blank if you do not wish to publish your address

Please give us a brief description of what your company does *

What is your current or intended website address? *

Please provide your company's mission or vision statement, and/or philosophy: *

What makes you different than your competitors? *

Please describe your target audience and geographic market(s). Please be as detailed as possible (Examples: age, industry, gender, income, geographical area, etc)

Please list three examples of websites that you like *

Please include at least 3 links of websites you like. What do you like and don't like about them?

Will you need web hosting for the new site? *

Yes
No

What section/infomation on your new site would you like to drive the most traﬃc to? *

Approximately how many pages will the new website initially include? *

Do you have a color scheme? If not, what is your color preference? *

What do you want your website to do? We need you to outline the features and functionality you'll be wanting to see on your website (this could be things like a secured members area, contact forms, file upload functions, newsletter form, blog, discussion forms, IDX integrations, or e-commerce). *

Are there any 3rd party applications or integration services that you would like to have on your website *

Will your company or organization be providing and organizing the content (text) for the website?

Yes
No

If No we will incorporate copywriting into your proposal.

Will your company or organization be providing images & photos? *

Yes
No

If No we would like to incorporate a photoshoot with our professional production team.

Do you need E-Commerce? *

Yes
No

Approximately how many products and/or services will be listed?

What payment processing system(s) does your company or organization use? ie. Stripe, PayPal

Are we doing product data entry?

Yes
No

If yes, how will you be providing your product data to us?

What is your timeline for this project? *

Please include any additional information or comments:

How did you hear about Marked Media? *

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Email: Info@markedmedia.net
Phone: 919.217.7747

Marked Media
P.O. Box 1555
Wake Forest, NC 27588

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