Thank you for your interest in StimulatedYet.com! If you may be interested in becoming a Stimulus Provider through our Website Design and/or Search Engine Optimization services, please take a minute to complete the form below.
This form will provide us with some preliminary information on your organization and your website. We will be in contact with you to review this information and further discuss your requirements.
NOTE: IXI and StimulatedYet.com do not design & develop websites that are obscene, vulgar, sexually-oriented, hateful, threatening, or otherwise violative of any laws.
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| Name: |
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| Organization: |
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| Address: |
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| City: |
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| State: |
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| Zip Code: |
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| Existing Website Address (If any): |
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| Phone: |
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| Email: |
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Best time to reach you: |
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| Best method to reach you: |
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| Organization Type: |
Start-Up Business
Non-Profit Organization
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General Business Category:
(Think "Yellow Pages" Listings Category) |
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| Annual Sales *: |
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| Number of Employees *: |
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* Optional. This information will be used in the Final Report, only within combined statistics -- to illustrate growth of organizations that have participated. This information will not be divulged as specifically related to your organization
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| Services of Interest: |
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| Website Design & Development: |
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| Website Copy Development: |
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| Website Updating & Maintenance: |
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| Website Application Development |
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| Web Video |
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Search Engine Optimization (SEO)
& Site Performance Analysis |
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| Social Networking Campaign Management |
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| Other: |
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Do you you currently have a Domain Name?:
(e.g. yourcompany.com) |
Yes:
| No:
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| If "Yes", What is it?: |
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| If "No", Please enter three choices for Domain Names that would work for you: |
First Choice:
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Second Choice:
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Third Choice:
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Objectives of Website:
(What do you want the website to
accomplish for you?) |
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| What Products / Services do you offer?: |
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| Main Target Market: |
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| Is your Target Market Regionalized?: |
Yes:
| No:
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| If so, what is your Target Region (State(s), Counties, Cities, etc.) |
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| Existing Logo?: |
Yes:
| No:
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| General Color Preferences: |
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| Slogan: |
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| Do You Have Brochures / Printed Materials?: |
Yes:
| No:
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| Main Navigation Preference: |
Top:
| Side:
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| Photography: |
Stock Photos:
| Client Provided JPG Images:
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| Other Sites That You Like the "Look & Feel" of: |
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Website Address
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| Competitors |
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Company
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Website Address
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| If we proceed with the project, please apply Stimulus Dollars generated: |
If you choose this option, please identify the participant below:
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| NOTE: Businesses and organizations receiving websites created with "Stimulus Dollars" must become paying participants in the Website Performance Analysis and Search Engine Optimization (SEO) program, thereby recycling funds back into the program and creating "Stimulus Dollars" to pay forward to others. Our goal is to help those who will help themselves and in turn help others. |
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| NOTE: Completing this form does not commit you (the client), IXI or StimulatedYet.com to the project. A representative of StimulatedYet.com will be in contact with you to discuss the details of your project. |
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Additional Questions or Comments?:
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