Free Site Estimate

Please take the time to fill out this small form to better serve you. Give us an idea on what you are looking for, so that we can give you a quote. Please no adult oriented sites. Any questions please contact us.

Contact Information
Please fill out completely inorder to email, fax, or mail your Quote to you.

Your Name

Business Name

Address

City

StateSelect StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth Dakota OhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermont VirginiaWashingtonWashington D.C.West VirginiaWisconsinWyomingOutside US

Zip Code

Your E-mail Address? Please Double Check It. Need it to get back with you!
(e.g.: you@aol.com)

Contact Phone No. Incase we can not contact you by email.

Fax No. Incase we need to fax your quote.

Web Site Information

Do You Have A Web Site Now?
 Yes or No

If So, Would You Like Us To Refresh It?
 Yes or No

Your Home Page URL?: (e.g.: http://yourpage.com) We would like to check out your page:

Web Pages (Pages Average $100.00 and up.)
How many pages for text and images do you have in mind.

Select OneOne Page2 Pages3 Pages4 Pages5 Pages6 Pages7 Pages8 Pages9 Pages10 Pages11 Pages12 Pages 13 Pages14 Pages15 Pages16 Pages17 Pages18 Pages19 Pages20 PagesMore than 20

These are additional Page offers that you might want in your Web Package
(Pages @$100)
 Type-in Order Form / Print & Fill-in Order Form
 E-Mail Contact (Required info by e-mail)(Mail Form / Questionnaire Form)
 Guest Book
 Message Board
 Link Page includes 10 links Any additional links $3 ea.
 Advance Link Page $100 setup fee / $20 hourly maintenance to keep updated.
 FAQ Page up to 6 FAQ.
 FAX Form
 Mail-in Form: Print then Fill in

Other Items you might want to add to your site:
 Direction Map ($50)
 Additional Images or Scan Photos (we offer small & large of $3)
 Clickable Link for Guest Books
 Design Company Link Banner (for advertising on link pages or guestbooks) $30.00 up

Will You Need To Have Your Site Maintained?
 Yes or No

If Yes, Which Of These? 
 Monthly Quarterly Yearly

Would You Like Us To Host Your Site?
 Yes or No

Which size hosting plan would you like to purchase?

Please select oneValue Plan 50 mb Pro Plan 100 mbMega Plan 200 mb

Please read our Acceptable Usage Policy

What Domain Name (Business Name/Web Address) Do You Have In Mind?
 .com.org.net.infoOther

Would You Like A Estimated Quote?
 Yes or No

Please Describe Your Business or What Your Site Would Be All About?

Do you have any other comments?

How did you find us? What Search Words? (Very Important To Us!)

Did you provide a correct E-Mail address above?

To send to Blais Web Creations,
Thanks for your time!