First name Last name Cell Phone Number E-mail Address Your Company Web Address What do you do? Television / Film Production Real Estate / Mortgage Broker Dental / Medical Practitioner Nightclub / Bar / Lounge Entertainment Venue Boutique Hotel / Resort Restaurant / Supper Club Health / Sports / Fitness Retail Store / Hair Salon Software / Technology Other How long has your company been in business? What can Life do for you? Marketing Management Web Design Graphic Design Flyer Distribution Visual Projections E-Mail Newsletters Online Networking SEO Optimization Other If you don’t have a website, but do have a domain name registered, what is it? Who are your main competitors and what are their URLs? What is/will be the main purpose of your Web site? What!? Im not building a website Branding / Identity Reinforcement Corporate Communications Online Sales Customer Service Resources / Education Online Networking Entertainment Other What is your time-frame for this project: Please describe your long-term goals for this project: What is your budget for this project: Please list any websites or advertisements that you know of that suit your style: Please describe your target audience: Please describe any special issues, limitations, or concerns that you know of: When is the best time to contact you? 
