New Service Questionnaire Name* First Last Email* Enter Email Confirm Email Phone*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Organization (if applicable)Does your site currently exist?*No, we're starting fresh with a new site.Yes, a site exists but we want to have it rebuilt or redesignedYes, you will be adding functionality or updating content on an existing siteDo you own the domain for the new site?*For example: www.mysite.com or http://mysite.com.Yes, we will be transferring it from another siteYes, it has been purchased but it has not been activatedNo, I will need you to help me find a domain and purchase itNo, but I will take care of it myself. Proceed with a temporary domain.Current Website* Is your current site built in WordPress?*YesNoNot sureCurrent site trafficNumber of visitors per month, general analyticsCurrent site sizeIn other words, the amount of space it takes on the serverWhat do you like about your current site?*What are you looking for in a redesign or rebuild? What would you like to improve on your current site?*Site and Hosting credentials1. Visit https://saltify.io and create a new secret ("Add Salt To Taste")2. It should last for 3 days3. Include site, hosting, and any other credentials with login and password4. CREATE A PASSPHRASE5. Enter the "secret" web link they give you below (select the "copy" button next to the link and you can then right-click "paste" into this field.)6. Text the passphrase to (573) 268-1383 What sections do you want on your landing page* Large header image (If you don't have one, we can help select one for you to purchase. Cost will range from about $12-$50) Contact Form Testimonials Features and pride points In the News About the Owner (please provide headshot) Social media stream (Facebook, Twitter, etc...) Existing multimedia or interactive presentation Photo Gallery Staff images Call to Action (Donate now! Call for more information! etc.) Up to six options, or you can keep your home page very simple for a more direct message (such as for an art gallery).What are you looking for in a new site? What functionality should it have?*Are there any sites you particularly like that we should use for reference? Why?Are there any sites that you do not like? Why?Does this need to be completed by a specific date for an event or presentation? Please only use if there is an actual deadline, allow at least 3 weeks. Date Format: MM slash DD slash YYYY Upload filesAccepted file types: pdf, doc, docx, txt, jpg, png, jpeg.Please upload any additional documentation which might be useful. Examples include logos, styleguides, etc. Additional Contacts and StakeholdersPlease list the names and email addresses of any additional contacts and their role in this project. Please note that most communication will be with a single primary contact.What else should we know about this project?CAPTCHA