DrWebs.com Information Form
  Please fill out the information below so that we can evaluate your needs to prepare a proposal for setting up a Web Site.
1. If you currently have a URL address please list it here

If not please list several names you might want your Web Site address to be. Many names are already unavailable as you can imagine. No spaces are permitted. Hyphens are excepted.
Example (CNN.com, ABC.com, charliesoddsandends.com, janes-shop.com ) ( Other popular domain extensions are .biz, .info, .ws (for businesses), .org (for non-profit organizations), .edu (for educational institutions), .net (for networks), .mil (for military) and .gov (for government agencies). ) 

  1. 2. 3.

4. 5. 6.

  2. List any words that you would think a person would type into a search engine to find your web site ( list up to 50 words and or phrases). Please put commas between your words and phrases.
  3. In the text box below please type a description that you want the search engines to list you like.
Example: ABC company, specializing in widgets located at 123 west Main Street, Detroit, Michigan
phone 555-123-1234.
  4. How many pages do you think you would require besides your home page ?
  5. Would you have changing inventory ? Yes    No
  6. If yes how often would the site need to be changed? Please check appropriate answer below.
daily       weekly     bi-weekly     monthly      bi-monthly       yearly
  7. Would you require a list of your sale items ? Yes   No 
  8. Would you want pictures of your sale items ? Yes  No 
  9. How many sale items would you have at any one time ?
  10. What is the name that the Web Site address will be owned by?
  11. What is your address?           Company name
  Business Owners name    Street Address
  City State Zip
  12. Phone numbers you can be reached? 
  Home
  Work ext.
  Cell
  Pager
  13.  E-mail Address   
  14. Is this the address that you want your E-mail correspondence sent to ? Yes  No
  15. If (No) would you like us to set up one for you ? Yes  No
  16. If (Yes) then list the E-mail address you would like example: tom@yourURL.ext 
  17. Referred by   

Please list any Additional Information you feel may be needed in this text box below.