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Are you interested in web design, re-design or a web site face-lift? Please fill out the following form. We then can begin to immediately assess your business needs and serve you better.

We respect your privacy and will keep all infomation confidential. By filling out this form you are under no obligation to choose our services for your web site needs. Someone from Ataj Solutions, Inc will respond to your request within 24 our less.

* Required Fields

BASIC INFORMATION
Name:*
Title:
Business Name:
Address:
City:	State: Zip Code:
Phone:	- - ext.
E-mail address:*

Length of time in business:

Annual sales:

Number of Employees:

GOALS AND STRATEGIES

Do you have your own company logo? Yes No

Do you have your own domain for this business or any other domains (URL)? If so, please list all URLs:

What do you think you need most from a web site?

What are the primary goals for your website?

What are your business objectives of the site website?

Establish a Web presence	Offer customer service
Increase marketing and product branding	Combination internet/intranet
Increase sales	Build store or business traffic
Generate business leads	Provide latest information
Increase international presence	Build a database for online store
Generate requests for information	Survey customers/prospects
Support existing advertising, promotional efforts	Text box admin area for latest news

Other:

What is the production schedule for the site, including intermediate goals and dates?

What is your estimated budget for your web site development and maintenance?

Gross annual income expected from website efforts:

OTHER REQUIREMENTS

Please check the items that you would need for your online presence.

Domain Name Registration	Web Video, Flash Elements, Web Audio
Web Hosting	Graphic Design (web image, logos, etc.)
Consultation	Search Engine Submission
Web Redesign for better look, feel, functionality	Internet Marketing and Promotion
Content Writing	Strategic Marketing and Promotions
Stock Photos and Images	Website Maintenance
Custom Photos and Images	Improved Search Engine Ranking

Other:

What period of time do you want to launch your website?

Do you feel you would need consultation in planning & applying strategies to your online presence? Yes No

How did you find Ataj Solutions, Inc:

Additional Information: