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Please fill out the form completely before you submit.

Please take time and fill out each of the areas of our form completely. This information will be used in the design of your website and any missing information will not be added to your website or designed/coded at our best discretion.

Please Note: We cannot begin the site design or layout for your website without the page titles and color choices. All content should be sent using the form or emailed to the address above as soon as possible. No content will be placed on the website until ALL content is collected.



This information will be used in the setup of your website as well as the contact information associated with your project. Please make sure that all information is accurate.


* Company Name:
* Contact Name:
* Your Website URL:
* Your Current Email Address:
* Confirm Current Email Address:
* Phone Number:


This information is in regards to a current website that you may have online. We need the following information to be able to access the domain, hosting and or files related to your current website. If you do not have this information available, please obtain it. Your current domain cannot be pointed to our servers without it. If you do not have a current website please skip the following section.


* Just to verify we are building a showcase or (shopping cart) or custom website for you?
* If building a shopping cart, how many products do you need to sell on-line, give me a quantity range?
* If building a shopping cart, what specific website or websites do you want us to use as the blueprint to build your website?
* Is the website going to be to selling to consumers or businesses?
* Do you wholesale or retail your services?
* If building a custom website, what specific functions do you need your website to have such as a login page or different database? Please be specific as to what you need with similar example sites or provide us with more detail as to what you need your site to do?
* Do you want to keep any of the content from your current website?
* What are the categories you want on your website, such as home page, about us, services , etc.?
* Are there any additional sub-categories or other categories you want to have on your website?
* How long have you been in business and give me a bio or brief history about you and your ownership of this business?
* What would you say your mission statement is?
* What makes you better or different than your competition?
* What type of guarantee do you offer?
* Do you have any discounts that you offer?
* Can you please explain your services in more detail?
* What products do you sell?
* Are you a franchise or independently owned?
* Do you want a map on your contact us page?
* What phone numbers do you want on your website?
* What email address do you want on your website?
* Can you send me some pictures for your website of your work, employees, and or products or do you want us to pull stock photos? If we need to pull stock photos we need to know specific types of photos to pull:
* What else do your feel would be helpful to mention on your website in addition to what we have discussed?
* Do you prefer us to update your website when you need to make changes or do you want to make the changes yourself?
* Do you want an estimate or quote form on your website? If yes please tell me all of the information you need to be filled out on the form for the estimate/quote/order form:
* Do you want any add-on features such as a new logo designed, an additional photo gallery, an animated slide show, or any other specific functions on the home page or any other page of your website? Be specific please.
* Are you needing any email accounts setup or transferred over? Email is typically setup or transferred when the new website is ready to go live. Your email can stay the same. If Yes, please spell out the email accounts you need us to setup and the passwords for each:
* Additional information that needs to be on the website:


Please help us develop a website that works for you. Give us some information on the purpose this website should serve for your company. This will give us a target for functionality as well as provide areas that we need to pay special attention to. We do understand that most websites could fit into a number of these target areas, we ask this only to help focus the website on your specific target.


* Package:

* Website Goal:

* Keywords:



This information will be used in the creation of the layout of your project. Any specific notes as to the design should be described in detail below. This will give our design team an idea of your likes and dislikes and helps in creating a project that reflects the design of your business.


* 3 Colors (light,medium,dark):

* Websites I Like #1:

* Websites I Like #2:

* Websites I Like #3:

* Do You Have A Logo:

Yes :       No :  

* Logo Notes: If you already have a logo skip this box.

* Design Notes:

* Layout Notes: Please Describe Everything You Like About The Websites You Listed And Any Other Design, Layout Or Function Requirements.



Please verify that all information submitted below is accurate. This information will be used to pay for the setup fee (if any) and the monthly payments. Please make sure to read and accept the MyInternetPartner.com terms and conditions.


* Contract Submitted:

Yes :       No :  

* Terms And Conditions:

Read Before Continuing

* I Have Read And Agreed To The MyInternetPartner.com Terms And Conditions:

Yes :       No :  

( You must fill in the fields marked with a * )
( These items may affect the pricing or your setup or monthly fee * )


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- Database Development
- Mass Email


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MyInternetPartner.com
4219 Hillsboro Rd.
Nashville, TN. 37215
Customer Service: 615.370.3013
Fax: 267.295.2540
website@myinternetpartner.com


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