quote request form | Civic Pixel

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quote request form

Please take 5 minutes to fill out the form below. Only fields with a red star are required, but the more information you can provide us with the more accurate our quote will be.

Basic Information

Business or Organization Name:

Contact Name: *

Phone Number:

If you would like us to contact you by phone please leave your number.

Email:

Alternatively, if you would like us to contact you by email leave your address here.

Preferred Contact Method: *

How would you like us to get in touch with you about this quote?

Brief Description of Organization: *

Please tell us briefly about your organization's mission, purpose, services, etc.

General Project Information

Website Type: *

New website

Redesign of existing website

Conversion of existing website to Drupal

Adding functionality to existing website

Existing Website URL:

If you already have a website please enter the url here.

Purpose of your Website: *

Briefly describe the purpose behind your new website.

Budget: *

Website Specific Information

Logo: *

Pages: *

Take your best guess at how many unique pages your website will have.

Functionality (select all that are applicable): *

Informational (text, pictures, blog, document attachments)

Multimedia (video, audio etc.)

Content Management (organized publications, document libraries, video and/or audio repositories)

Web Application Development (advanced custom functionality, example: a form that identifies a user's congressional district and representatives.)

Community (user signup and login, member features)

Simple Payment Processing (donations or payments through PayPal, Network For Good, etc)

Advanced Payment Processing (using a business merchant account to process credit cards and take payments directly)

Constituent Management (database systems to manage users, send mass email, track campaigns and interaction with members, manage memberships and contributions)

Please select all of the above that apply to your project.

And finally...

Questions or Comments:

If you have any specific questions or comments, please leave them here.

How did you find out about us?:

We love giving credit where credit is due. If you heard about us from a friend, another website, a search engine or anywhere else please let us know!

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