Name
Name of Organisation/business
Type of Work
Address
Telephone
E-Mail
Type of Web Site Required	choose from list personal web site business web site organisation web site
Anticipated no of Pages	1 - 5 6 - 10 10 - 15 15 - 20 20 - 25 more than 25
Do you require a logo creating?	Yes No
images/text by e-mail/disc?	Yes No
Other Comments