	Questions?

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Please fill out as much as possible in the form below to allow us to better understand the type of Web site you want Webecorp™ to create for your company. We will contact you with a quote.

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Online Quote

Contact info

*=Required

*Name

*Address

*City:

*State:

Zip:

*Contact Phone

Contact Phone 2

Best time to contact

*E-mail address

*Company Name

Other information:
(include here any information
regarding E-commerce sites,
questions you might have,
0r other pertinent information)

Site Information

Do you have an existing site

Current site address: www.

* Type of site:

Have you visited a site you would like it to resemble?

www.

Pages you will want on the site

	About	Products	Events
	Contact	Services	News archive
	Forms	Newsletter	Our Company
	Our Stores	Public Relations	Investor Relations
	Technology	Store Locator	Online Shopping
	Annual Report	Corporate Info	Employment
	Partners	Store Development
Other:

Number of Graphics

Estimated Number of Pages

Number of Products

(if selected 'Products' above)

Design

	Simple
	Information & Interface
	E-Commerce Style
	Other (comment below)

Other:

Estimated Hosting space required:

Services you will require

	Web Hosting	Domain Name Registration
	Design New Site	Search Engine Optimization
	Update Current Site	E-mail Redirect Setup
	Consulting	On-line Catalog
	Large E-commerce Solution	Statistics Reports
	Ad Banners	Other (comment below)
Other