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Thank you for your interest in having us assess your website requirements. This form will be able to give us a good understanding of your needs in order to provide you with a detailed quotation for what and how we would do to satisfy those necessities.
It shouldn't take you any longer than about 10-15 minutes to complete the questions.
Organization Name *
Contact Name *
Contact Title
Address *
City *
Province / State Outside Canada & US Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware Distric of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific
Postal / Zip Code *
Country Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Timor-Leste Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia, The Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles New Zealand Nicaragua Niger Nigeria North Korea Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe *
Telephone *
Fax
Email Address *
Industry *
How many years in business? 1 2 3 4 5 6 7 8 9 10 10 - 15 16 - 20 Over 20 *
How many staff do you have? 1 2-5 6-10 11-25 26-100 100+ *
Who are your customers? *
What are your Customer Demographics? *
What is your competitive advantage? *
Who are your competitors? *
How do you generate business? *
Complete this section only if you already have a website or registered domain name.
Do you have a registered domain name? Yes No *
What is your domain name?
Do you have an existing website? Yes No *
What is the URL for your website?
Website Username
Website Password
Website Name
How big is your current website?
How many visitors do you have per month?
What current features should be kept?
What current features should be removed?
What feedback have you received ?
Where is your site currently hosted?
What is your current hosting cost?
What operating system is your server? Linux Microsoft Other/Don't Know
What Services does your host provide? FTP (File Transfer Protocol) cPanel / Plesk PHP 5.x+ MySQL 5.x+ mod_mysql mod_xml mod_zlib
If you plan to sell online, does the host offer SSL Security? Yes No Don't Know
What is the primary reason for your website? *
To establish a web presence or enhance marketing and product branding. Yes No
To create a news portal. Yes No
To create an online community. Yes No
To use as an sales tool for your organization. Yes No
To generate business leads Yes No
To enable or increase online sales. Yes No
To increase offline sales Yes No
To distribute wholesale product information and price lists. Yes No
To generate requests for information Yes No
To support existing advertising and promotions. Yes No
To provide customer service. Yes No
To build an email marketing database. Yes No
To provide access to a new online application. Yes No
To recruit new employees. Yes No
To provide an online sample portfolio. Yes No
To survey customers/prospects Yes No
Preferred Layout 1 Column 2 Columns 3 Columns 4 Columns 6 Columns Custom Layout *
Layout Style Conservative Business Modern Web 2.0 Bold Aggressive Light-hearted Fun Whimsical Ethereal and thought provoking *
Primary Accent Color
Secondary Accent Color
Third Accent Color
Other Layout Ideas (180 chars left)
Home Page *
Privacy Policy *
Website Disclaimer *
Site Map *
Secure Backend Admin *
About Us
News or Blog
Products and Services
Contact Us
FAQ (Frequently Asked Questions)
Web Links
Will your Content be Categorized? Yes No
What categories will you use? (120 chars left)
Will you require multi-level categories? Yes No
Will the categories link to products and services? Yes No
Will you require a user blogging system?? Yes No
Will you be embedding external content? Yes No
Will you require an image gallery? Yes No
Will you require an audio or video gallery? Yes No
Will you be embedding multimedia from other websites? Yes No
Will you be embedding video in pages? Yes No
Will you be selling subscriptions online? Yes No
Will you be selling products online? Yes No
Will you be running online auctions? Yes No
Will you be accepting online donations? Yes No
Will you be selling advertising online? Yes No
Will you be using online billing and payments? Yes No
Will you host online forums? Yes No
Will you offer online chat support? Yes No
Will you offer email newsletters? Yes No
Will you require online scheduling? Yes No
Do you require custom forms on your site? Yes No
Do you want to take opinion polls? Yes No
Will you make available a user commenting system? Yes No
Will you be providing an online community? Yes No
Will you require advanced User Management? Yes No
Will you enable user-defined groups in your community? Yes No
Do you require a user-wall and/or friend system? Yes No
Do you want your website integrated with other social networks?? Yes No
Do you want to enable intra-user instant messaging? Yes No
Do you require search engine friendly web pages? Yes No
Do you require enhanced Meta Tagging? Yes No
Do you want to enable user tagging? Yes No
Do you require an on-page Tag Cloud? Yes No
Do you require links to social bookmarking sites? Yes No
Will you require "captcha" style form security? Yes No
Will you require multiple source authentication? Yes No
Will you require multiple website administrators? Yes No
Will you require users to be registered to add content or comments? Yes No
Do you want us to be responsible for website security upgrades? Yes No
How much ongoing site-maintenance and updating will be required? None, we'll do it ourselves 1/2 hour/mth 1 hour/mth 1.5 hours/mth 2 hours/mth 4 hours/mth 8 hours/mth 8+ hours/mth
What is your budget for the design and development of your site? $0 - $499 $500 - $999 $1000 - $1499 $1500 - $1999 $2000 - $2499 $2500 - $5000 $5000 +
What is your monthly budget for website updating and maintenance? $0 - $49/mth $50 - $99/mth $100 - $149/mth $150 - $199/mth $200 - $249/mth $250 - $500/mth $500+/mth
How soon do you intend to launch your new website? Immediately (RUSH!) Within 1 month Within 3 months Within 1 Year Not Sure
Anything Else? (480 chars left)
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Thank you for completing our Needs Analysis Worksheet in order to provide us with the much of the information needed to enable us to quote on your website project. We will be in touch shortly to answer any questions you may have and discuss your needs further.
A copy of your completed form has been sent to the email address you entered on the first page.
In the meantime, if you have any immediate questions (or if you simply can't wait), give us a call at 1-905-773-5079 to discuss you project in more depth.
Thanks.
Scott Binnie
