| (* Indicates Required Fields) |
| Expected cost of website? * |
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Website URL (if applicable) |
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| Service Needed * |
New Web Site Development
Existing Site Design
Others |
| Products Needed * |
eGovMall Intranets
eGovMall Section 508 Compliance
eGovPal
eGovMall Blogger
eGovMall Website Packages
eGovMall e-Rolodex Directory Software
eGov Web Optimization Packages
eGovMall Certification SSL
eGovMall Email Certificate
None |
| Website Platform |
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| Additional Services Needed |
Site Maintenance
Get out the calls
eFax Services
Database Maintenance/Collection
Design Web/Print
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| Do you have digital images? |
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| Will Your Site need to be Section 508 or ADA compliant? |
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| Multimedia Options |
Flash Animation
Audio
Video
e-Postcard
e-Yard Signs |
| Additional Options |
Banner Ads
Site Statistics
Administrative Interface
Credit Card Processing
Security Features
Shopping Cart
Site Search |
| Describe Your Project in a Few Sentences |
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| Please describe your project goals in as much detail as is convenient. Please also note any pertinent technology, software or platform requirements. |
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| How to Contact you: |
| Your full name * |
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| Organization/Association * |
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| Phone number * |
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| Email Address * |
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