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REQUEST FREE ESTIMATE FOR WEB DESIGN

Use this form to obtain a Free Estimate of costs for your website, or contact me at .

Your information will be kept strictly confidential. LaFemmeGeek will not share any personal information it receives with any other individual, organizations or mailing lists.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please complete and submit the form below and LaFemmeGeek will contact you shortly.

Name:
*Required

Business Name: (if any)

Email:
*Required

Phone:

 

What type of website do you need: (check one)

Personal
Business
Ecommerce

Please describe:

Is this a new website or do you want to redesign an old one?

New Website
Redesign

Please enter the approximate number of pages required, if known:

5 or less
Between 5 and 10
More than 10

Will your website require any forms?

Yes
No
Not sure

Will you require any photography or custom graphics, i.e., logo design or will you provide your own?

If you are requesting a redesign of a website, please provide the address of the website below:

How would you like to improve this website?

Please provide any additional information here or use this space for questions you may have: