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Title DR MISS MR MRS MS

First Name *

Last Name *

Email Address *

Work Phone Number *

Web Address *

What are the goals of your website? Capturing leads for your products/services Building a customer database for marketing purposes Selling products/services online Capturing bookings for your events Building a community around your business Service your existing customers / provide "Member Only" content

Primary Goal and Calls to Action - what do you most want your visitors to do? E.g. I want to grow my customer database.

What specific features do want in your website? Email marketing Online shopping catalogue "Contact Us" form Payment collection form Discussion forum Blog Member Only area Event bookings Searchable list of articles News & announcements Frequently asked questions (FAQ's) Document downloads

Do you require email accounts? No Yes

Describe your target market(s). E.g. Where do they live, how old are they, who makes the buying decision?

Current Advertising - What methods do you use for advertising? Word of mouth Newspaper Radio TV Magazine Internet Other

Any other comments you would like to add?

Are there any problems with your existing website or website provider?

What system(s) do you use to record the details of your existing customers? E.g. Outlook, CRM, Excel...

Online Marketing - What methods do you currently use to market your business online? Email Newsletters Pay per Click e.g. Google Adwords Search Engine Optimisation

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