Client Sign Up Form

The client sign up form below gives us a better understanding about your website needs. We use this information to put together a proposal for you. Of course the more detail you provide us with the better off we at providing a more accurate proposal.

Once you submit your client sign up form you will be directed to a proposal payment page. This page outlines the payment process for the proposal ($125.00 fee). Please note -this proposal fee may be waived in certain circumstances.

The team at Pure Web Group works very hard at providing you with a top notch proposal that convers all aspects of your service request. We also do an extensive amount of preliminary research in order to get you the best solutions. This proposal is yours and you are free to shop it around to other designers if you desire.

We are confident that you will find our prices & service to be above par. When you accept our proposal and use our services we will discount your final quote by $40.00.

You may be contacted via email or phone if more detail regarding your request is needed.

*when filling out this form be sure to copy and paste your answers into a text document such as word or notepad. This prevents any information loss should you happen to disconnect from our site before submitting the form.

If you have any questions please email info@purewebgroup.com or click here to fill out a webmail form.

Name (full)

Mailing Address

Phone #

Cell #

Service Request New Website Website Redesign/Upgrade Add To Current

Current URL (if applicable)

Project Overview Please describe the project/service request. The more information you provide the more detailed our proposal will be (please select this text and delete before writing).

Desired Features (multi-select hold CTRL)

Other Features Please list any additional features that you would like on your website.

Layout & Design Please describe the desired layout & design of your site. Be sure to include any information about the style, colors, theme etc. Feel free to include URLS from other websites in here as reference as well. Please be as detailed as possible.

Estimated Web Site

Page Requests

Other Pages Please list any additional pages you would like.

Will This Site Have An Online Store? Yes No

Approx. # Of Products

What Kind Of Products Are You Selling Online?

Will You Need A Domain Name Registered? Yes No

Domain Name Request Please list the domains that you would like us to register for you in order of preference.

Hosting Needed? Yes No

Additional Information Is there any additional information you would like to include?

Discount ID