Your Name:*	Name is required.
Your Company Name:*	Name is required.
Your Email:*	Field is mandatory Email address is invalid.
Your Contact Phone number:*	Field is mandatory Must be numeric Characters
How many many pages you anticipate for your website:	No idea 1 5 10 20 40 >40
Give us us reference sites (example sites): (for example: www.omsai.com)
Do you Have Domain name registered ?:	Yes No
Do you have Hosting provider for your website ?:	Yes No
Website Time Frame:	1-2 Weeks 2-4 Weeks 1-2 Months 2-4 Months Over 4 Months
Please describe any extra features you would like to have: (Flash intro, Flash website, Logo design, etc) (maximum 500 characters)	Would Like:  Characters Entered
Any Additional Infomation/comments you would like to provide us: (maximum 500 characters)	Additional Info/comments:  Characters Entered