Website Design Form

    Your Client ID:

    Company Profile

    1. Your full name:

    2. Name of your business:

    3. Your company slogan:

    4. Your company email:

    5. Your company phone:

    6. Your website/domain:

    7. Your company address:

    8. Twitter account:

    9. Facebook account:

    10. MySpace account:

    11. LinkedIn account:

    12. YouTube account:

    13. Any other social media account(s):

    Company Details

    1. What does your business do?

    2. When was your company established?

    3. Number of employees/staff:

    4. Describe the products/services you sell.

    5. What is your typical customer like?

    6. What is your target audience?

    7. If your primary customers/clients are local, what surrounding cities are you targeting?

    8. What are your top 3 frustrations with your current website?

    9. What do you like most about your current website?

    10. What do your current competitors website have that you aspire to? Provide links if possible.

    11. What makes you stand out apart from your competitors?

    12. Name 3 things that are most important about the design of your new website.

    13. Name 3 things that is least important in the design of your new website.

    14. Do you have any color preferences, existing brand colors, and/or colors you do/not wish to include?

    15. Please provide the wire-frame layout you like best:

    Please select from below (clicking on images will open in new tab/browser):

    16. Will this be an e-commerce website? Will you be selling any products or taking payments on your website? If so, how are you accepting payments?

    17. Do you have all images that you would like to be included in your website or would you like the designer to use images where appropriate?

    18. If your site is already registered and hosted, please provide us with the “cpanel” login credentials. If you do not have one, please get it setup and let us know ASAP.

    Other Details

    1. Deadline, timing or exact date of completion for your website (rush delivery fee of $300 applies if less than 30 days, otherwise ignore):

    2. Is your logo and other images web ready? Or do you need a new logo? If so, please explain what you would like (color, shape or any other descriptions):

    3. Do you need a copywriter? If you are using existing copy on your current website, will it need to be modified in any way?

    Keyword Research

    1. Do you have access to your Google Analytics and Webmaster Tools? If so, please provide us with your login credentials:

    2. If you do not have one, please let us know what email address you would like to use as the primary account:

    3. What keywords do you *think* you should be ranking for? I.E. Use as many descriptive PHRASES as possible to describe your business and what you do.

    4. Please attach any supporting files you wish.

    Please type in the code you see below:


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    Zimrock Marketing, Inc.
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