Member Information Request
For businesses interested in web site consulting services. Please complete this short questionnaire and provide your contact information below to receive more information about how to get started as a member.
Why are you interested in having a successful web site for your business? (select all that apply)
I want to promote my business to local customers
I want to improve customer service and relations
I want to sell my products or services online
I want to expand my business and market area
I want my business to appear more professional
Other
Rate the following items in terms of their importance to you in choosing a web site consultant:
<<1 = Least Important ------------ Most Important = 6>>
1
2
3
4
5
6
Help with getting started and determining needs
Help creating initial web site content and design
Help with future web site updates and changes
Help and advice with web site marketing
One monthly price for ongoing support
Email and phone support always available
Face to face support available by appointment
Training to allow you to update your own web site
Rate the following items in terms of their importance to you regarding a web site for your business:
<<1 = Least Important ------------ Most Important = 6>>
1
2
3
4
5
6
Professional and attractive visual design
Easy to use and navigate the web site
Compelling, useful and up-to-date content
Easy to update and change by yourself
Customers can easily find your web site
Fast loading and always available for visitors
Custom design unique to your business
Ability to promote/sell products and services
Ability to communicate with customers
Rate the extent to which you agree with the following statements about the Web Site Partner service:
<<1 = Strongly Disagree ------- Strongly Agree = 6>>
1
2
3
4
5
6
I understand the service and how it works
I like having a partner always available to help me
I like having one monthly payment for all services
I think this service would suit my web site needs
Based on what you know about the Web Site Partner service, what do you like MOST?
Based on what you know about the Web Site Partner service, what do you like LEAST?
I would rather have a payment option where I:
Pay for all services and support in one simple and predictable monthly payment.
Pay for service and support in separate payments as they are needed
I would rather have a start up cost where I can:
Pay
less
up front to join but pay
more
per month.
Pay
more
up front to join but pay
less
per month.
How likely you would be to get started in the Web Site Partner service at each of the following costs:
<< Please select an answer for each cost >>
Definitely
Probably
Probably Not
Definitely Not
$149 per month with $0 up front cost
$129 per month with $0 up front cost
$99 per month with $0 up front cost
$69 per month with $0 up front cost
$49 per month with $0 up front cost
$99 per month with $499 up front cost
$69 per month with $999 up front cost
$49 per month with $1499 up front cost
$29 per month with $1999 up front cost
$19 per month with $2499 up front cost
Rate your level of skill/experience in the following categories:
<<1 = Very Low ----------------------- Very High = 6>>
1
2
3
4
5
6
Computer Operations
Internet Use / E-mail
Internet Sales and Marketing
Website Design / Development
Please tell us a little about your business and current web site (if applicable).
Type of business:
Number of employees:
Business market - local, regional, national, or international:
If you currently have a web site, how satisfied are you?
---------------Select Answer---------------
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Unsatisfied
Very Unsatisfied
If you currently have a web site, how important is it to your business?
---------------Select Answer---------------
Very Important
Important
Somewhat Important
Somewhat Unimportant
Unimportant
Very Unimportant
If you currently have a web site, approximately how much do you pay per month?
If you currently have a web site, approx. how much did you pay to have it created?
Thank you, please include the following information and we will contact you as soon as possible. Your responses will remain completely confidential and we will never disclose your personal information to anyone.
Business Name:
Contact Name:
Email Address:
Phone 1:
Phone 2:
Fax:
Address:
City:
Zip Code:
State/Prov:
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Arkansas
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[Outside US]
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Cook Islands
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El Salvador
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Neutral Zone
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Tajikista
Tanzania, United Republic Of
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Comments: