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EGWALD WEB SERVICES LTD.

INFORMATION FORM

Please provide me with the following information (as much as you want) about yourself or your organization. This information will help me to ascertain what web services you require, so that your website promotes the objectives of your organization. Do you need a guestbook, a chat room, a membership application form that automatically updates the membership data base, survey forms, information pages, a shopping cart, or photos of your executive members? If you need it, I can write a program to do it. Remember: keep it simple. It is cheaper and just as effective. Surf the web to find examples of sites that are like the web site you want for your organization. Contact me and let's get your website launched!

FIRST NAME / NOM

LAST NAME / NOM

TITLE / TITRE

ADDRESS / ADRESSE

ORGANIZATION / ORGANISATION

CITY /VILLE

     

TELEPHONE / TÉLÉPHONE     EXT

PROVINCE / STATE

FAX / TÉLÉCOPIEUR

COUNTRY

   

EMAIL ADDRESS / COURRIER ÉLECTRONIQUE

POSTAL CODE/ZIP CODE

Spam Control Number

Repeat Control Number to Process

Type of Organization

NON-PROFIT

PROFIT

PERSONAL

CLUB

Present Internet Services

EMAIL

WEB SITE

DOMAIN NAME

WEB SERVER

Web Services Required

WEB PAGE

WEBSITE

PHP PROGRAMMING

INPUT FORMS

MYSQL DATA BASE

OTHER

Consulting Services Required

WEBSITE CONSULTING

INTERNET CONSULTING

ECONOMICS

STATISTICS

OPERATIONS RESEARCH

NUMERICAL ANALYSIS

More Info


any other information you want to provide us

SUBMIT INFORMATION FORM

   

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