Your Name:

Your Email:

Daytime Phone:

Evening Phone:

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Company Name:

Type of Business:

Address Line 1:

Address Line 2:

State outside US Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachus. Michigan Minnesota Mississipi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Winsconsin Wyoming ZIP CODE :

Type of Project:
Starter Web Site E-commerce RealMedia CD Data Storage Video/Audio Presentations Graphic Print/Web Design
Time frame for completion: 6 months 3 months 1 month 2 weeks
Number of Documents to be used:
0-10 10-30 30-50 more than 50
Are documents being provided on:
3.5" floppy disk ZIP Drive CD ROM Hard Copy for OCR scanning
Number of graphics to be used:
0-10 10-30 30-50 more than 50
Are graphics being provided on:
3.5" floppy disk ZIP Drive CD ROM Photos for scanning
Special Project Information: