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Contact Name:
Business Name:
Business Street Address:
City State Zip:
Email Address:
Day Phone:
Project Type:	Brochure E-Commerce
Type of Business:	Service Retail Wholesale
Market Reach:	Local Regional National International
Program Preference:	Full Service Web Design Tutorial Undecided
Desired Start Date:	Yesterday In a Week or So In a Month or So
Desired On Line Date:
Written Content:	We will provide. We need you to provide. We provide, you edit.
Logo:	We have one. We need one.
Images and Graphics:	We have them. We need you to supply them.
Domain Name:	We have one. We need one.
Hosting:	We have a host. We need a host.
Project Overview:
Best Time to Call:	Weekday Morning Weekday Afternoon Weekday Evening Any Time


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