Insight Information Services

Project Evaluation Form. This form is provided as a first step in assessing your wants, needs and desires. Please feel free to be as verbose or as brief as you need to be in expressing what you are trying to achieve with a web site, web application, custom programming, etc.... The more information you provide up front the faster the project can get started!

Once this form as been submitted you will be contacted within 24 hrs. to review and evaluate your Internet/Intranet web services needs. We look forward to hearing from YOU!

Contact Information

Technical/Primary Contact Name:

Technical/Primary Contact Phone:

Technical/Primary Contact Email:

Contact me:

by E-mail by Phone

Country:

State / Zip:

Project Information

Subject:

Time Line:

Domain Name:

Is this a New Domain Name?

Web Site:

Web Content:

Web Content Examples
(sites you'd like yours to look like):

Web Content Screen Shot
(what you'd like yours to look like):

Upload .jpg or .gif image, max file size=100K

Files > 100K will NOT be uploaded

Web Application/Programming:

Web Applications:
(check all that apply)


Shopping Cart	Events Calendar
Guest Book	Photo Gallery
Staff Pics & Bio's	Search Engine
Discussion Forum	Blog
News Letter	FAQ's
Real Estate Listing Engine
Document Management
Advertisment Banners
Other

Web Forms:
(check all that apply)

Contact Form	Sign up for specials
Mailing List	RSVP Form
Inquiry Form	Custom Form
Email confirmations, appointments
Upload files and email them to me
Other

Custom Programming Information

I need an application/program to:

This program/web based application:

already exists and needs to be revised
is new and needs to be developed
Other

Server Side preference:
(check all that apply)

PHP	ASP
Cold Fusion	PERL
JAVA
Other

Client Side preference:
(check all that apply)

JavaScript	Flash
Style Sheets	DHTML
Other

Database preference:
(check all that apply)

Microsoft SQL	Microsoft Access
MySQL
Other

Application to send e-mail preference:
(check all that apply)

Closed Relay SMTP (Requires Login)
Open Relay SMTP (No Login Required)
Allow file uploads & email attachment
Other

Application read/writes server files preference:
(check all that apply)

File I/O (Requires Login)
File I/O (No Login Required)
Other

Application requiring login preference:
(check all that apply)

Members Login with separate accounts
Group Login accounts
Other

How did you find us?

How did you find us?

If you found us in a search engine, what keywords did you search?

If referred by someone, enter their last name and domain name.

Please add me to your mailing list.