KLB Web Solutions : Inquiry Form

Your Affordable Web Solution

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Inquiry Form

Please complete the following form to receive your FREE, no obligation consultation on your company's web solution. Filling out the form does not oblige you in any way. Please mention if you are a non-profit organization, start-up small business, or WAHM as we have special pricing packages.

When you are finished, click on the Send Via Email button to send the form to us via email. We will contact you within 48 hours after we receive your submission.

Fields denoted with ** are required fields to submit the form.

Client Name **

Mailing Address Line 1:

Mailing Address Line 2:

City, State, and Zip/Postal Code:

***Please double check phone number and
and email address to be sure they are valid,
or we will not be able to contact you.***

Phone Number:

E-mail address: **

How do you prefer to be contacted?
email phone
If phone, what is the best time of day to reach you?

Company Name

Nature of Your Business or Organization:

What is the purpose of your site?
Establish an ePresence
Provide Information: On-line Brochure
Sell Products
Provide a Virtual Community
Unknown

Do you already have a domain name?
No Yes Reserved But Under Construction
Existing Web Site URL, if applicable:

Will you need hosting services?
Yes No Maybe Unknown
Will you need site maintenance?
Yes No Maybe Unknown

Do you have promotional materials that
need to be scanned?
Yes No

Number of Web Pages Needed:

Any Special Tools Needed:

Type of Graphics Needed:
No Graphics, Text Only
Scanning of a Logo to Use
Simple Graphical Header with Clipart
Custom Graphical Work

How did you find out about us?

Project Details or Additional Comments:

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