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Web Design Enquiry Form

Title
Name
E-Mail
Web Site address
(if you have a web site)
Telephone
How do you want us to contact you? E-Mail Telephone
How did you find out about Velnet?:


Your website information

How many pages do you want in your website:  


Do you have Logo, graphics and contents waiting:

I have a logo Yes No

Yes No

I have text: Yes No Yes No
I have graphics Yes No Yes No


Domain Name Web Hosting Website Promotion

Do you need any of the above services?
I need a domain name : Yes No
I need web hosting : Yes No
I need website promotion: Yes No


Additional Information

Please give us a brief description of the look and feel you will like your
web site to have.

Please provide some web site address of the web site design you like

What is your preferred colour scheme?