Digital Agency | Digital Marketing and Development – 041 Agency
041 Digital Marketing Agency Newsroom
Blog Intake Form
Branding & Design
Business Directories Intake Form
Cart
Checkout
Contact Form
Digital Ad Intake Form
E-Commerce Asset Intake Form
E-Commerce Intake Form
How-To Videos
Job Dashboard
Jobs
Mobile Application
My account
New Client Intake Form
Personal Brand Reputation
Pitch Deck Intake Form
Pitch Decks
Post a Job
Press Release Intake Form
Privacy Policy
Refund and Returns Policy
SEO
Shop
Social Media Form
Social Media Management
This Is A Digital Agency That Does Simply Everything Digital
This is Our Digital Agency Portfolio of Works
Videography Intake Form
Website Design Form
Website Design Form
Website Design Form
Please enable JavaScript in your browser to complete this form.
–
Step
1
of 2
Name
*
First
Last
Email
*
Phone
Date / Time
Date
Time
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Company Name
What does your company do:
Next
Do you have an existing website?
Yes
No
Do you have a domain?
Yes
No
I want this site because:
I need to build awareness for my brand
I need to offer a contact point to my clients
I need my company to have a better image online
I need to sell my product/service through my site
I need to use it to build customer loyalty
I need to reach people in many languages
I need somewhere to promote my latest product/service
Other
My site will be built to target:
Business customers
Consumers
I'd like to target clients who are:
Kids & teens
In their 20’s
In their 30’s
In their 40’s
In their 50’s
Senior citizens
My Clients come to me because
I offer excellent service
I have the best products on the market
I have the best prices on the market
Average number of employees
Date Presented
Date
Time
Someone's searching the web for your business. What words or phrases will they search for in google:
What is it that makes your products or services unique on the market:
Do you have any proof that your solutions are better than your competitors:
Creatives
Who will provide the following resources?
Will you provide – Stock Photography
yes
no
Will you provide – Company Photography
Yes
No
Will you provide – Artwork / Illustrations
Yes
No
Will you provide – Translation costs (If needed)
Yes
No
Will you provide – copywriting text
Yes
No
Will you provide – Professional Logo
Yes
No
Will you provide – Graphic Design
Yes
No
Will you provide – Other print collateral
Yes
No
Will you provide – Font Licences
Yes
No
Design
Does your company have a logo / established image & branding guidelines (E.G Fonts, color schemes etc)
yes
no
Do yu have print materials (such as business cards or brochures) that we need to match
yes
no
Could you give us the websites of your top 3 competitors
If you had to pick 3 websites you would love to have, which would they be
What will happen once we deliver the site
Would you like us to update your site or would you like to be responsible for updates
Agency – (we update)
Yourself
How often would you require updates
Daily
Weekly
Monthly
Quarterly
Previous
Submit