Business Information

1. Business Name(required)
2. Business Category(required)
3. Business Address 1
4. Business Address 2
5. Main Telephone
6. Main FAX
7. Main Email(valid email required)

Contact Information

1. Contact Person's Name / Title(required)
2. Contact Person's Email(valid email required)

Hosting Services & Domain Names

1. Do you already own a website?
2. Yes (List your purchased domain names below)
   No (List your desired domain names below)
3. Domain Names
4. Who will manage the hosting and domain names?
5. I would like to register the domain name(s) and hosting to our company name, and by doing so I understand that I have full responsibility of the management and renewing of the domain name(s) and hosting plans.
   
   I want Pristine Minds to manage our domain name(s) and hosting servers. With this option, the domain names will be registered to Pristine Minds and booth domain name(s) and hosting plans will be registered and managed under Pristine Minds. Applicable annual fee(s) will be charged according to domain name(s) purchased and hosting plans selected.

Website Design & Development

1. How would you like your website to be perceived? (Design themes)
2. Clean & Simple Dark & Rich
   
   Vibrant & Colorful Elegant
   
   Decorative Fun & Exciting / Energetic
   
   Corporate / Serious Others
3. What is the purpose of the website? Please check mark all that apply.
4. Online display of services / products Online sales
   
   Increase brand image awareness Communication with customers
   
   Online marketing File upload / exchange
   
   Other
5. Number of products listed
6. Choose the approximate time frame of the website
7. One month or less
   Within two months
   Within four months
   Whenever
8. Who are your target audiences?
9. List the languages to be used

Additional Services & Options

1. Do you need translation services?
2. Yes No
3. Languages to be translated
4. Do you need copy writing services?
5. Yes No
6. Logo
7. I will use my existing logo.
   I want Pristine Minds to design a new logo for me.
8. Are you interested in our Online Listing Service?
9. Yes, I want to list my website on Google, Yahoo, and more.
   No
10. Are you interested in our Online Marketing Service?
11. Yes, I want to advertise on Google, Yahoo, and MSN.
    No
12. Do you need any professional photography services?
13. Yes, I want a photographer on my place.
    Yes, I will send you my products.
    No
14. Do you need any professional video production services?
15. Yes No

Additional Notes / Comments

1. Let us know if there are any comments you would like to make, or if there's anything else we should know about this project
2. Comments

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