Consultation Form

If you would like to contact the designers at Bad Dog Web Design about creating a new web site, re-designing your current website, hosting and/or managing your site, or any of our other services, please fill out the web form below so that we may better access your needs.  Our designers will contact you promptly to discuss your interests.

Name
Street Address
City
State	Select a State Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Flordia Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Not in the US
Zip Code
E-mail
Telephone
Cell Phone
FAX
What is the name of your business? Do you currently have a web site?  YES    NO Please enter your current website address:

I would like information on the following:

	Designing and/or creating a new web site
	Creating and maintaining a new web site
	Re-design an existing web site
	Maintaining an existing web site
	Transferring your web site
	Original graphics or logo design
	Basic set up (Main Page and 2 free pages)
	Additional Pages
	Basic Graphics (Banners, Images, Navigation Buttons)
	Advanced Graphics (Custom Photoshop, Hover Buttons, Flash animation, Movies, Slide Show Formation, Tables, Graphs, PowerPoint Presentations)
	Picture transfer and editing
	Flash animation - basic
	Flash Animation - advanced
	Graphics or Flash animation with music or sound
	Contact Pages for email response
	Digital Photography
	On site training to maintain your own site
	Web site hosting service
	Standard- Set up and Design Package
	Advanced  - Set up and Design Package
	Deluxe - Set up and Design Package
	Other

         Please enter additional information in the space provided below: