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Home
About
Blog
Services
Email
Maintenance
SEO (Search Engine Optimization)
Social Media
Advertise
Referral Program
Contact Us
Schedule a Free Phone Consultation
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YOUR CART
Our Design Survey
Client Web Site Design Survey
Understanding what a client really wants is one of the most difficult tasks for the designer. Answering these key questions will be invaluable to streamlining the design process. With this information, we will be able to work quicker and more efficiently to meet the desired goal and deliver satisfying results.
After you have subscribed to either a Single Coalition Membership Website Subscription or a Statewide Coalition Membership Website Subscription, please take the time to fill out as much of this form as possible. If you are unsure about a question, or it seems irrelevant, leave it blank.
Coalition Name
*
If you subscribed to a Statewide Subscription, please enter the name of all of the Coalitions within your State
*
List one Coalition per line please.
List Counties in Coalition
*
List one county per line
Coalition Contact Name
*
First
Last
Coalition Contact Title
*
Coalition Contact Email
*
Coalition Contact Phone
*
Coalition Contact Mobile Phone
*
How would you prefer us to contact you?
*
Email
Phone
Mobile Phone
Preferred URL (ex: www.mynewwebsite.com)
*
A domain name is included with your website subscription not to exceed a value of $20. Should a more expensive domain option be chosen, the cost difference will be added to the overall subscription.
Photograph(s) for Header
*
I have a photograph(s) for the header
I need a photograph(s) for the header
Not sure at this time
List the top six hazards in your coalition region
*
We match photos on the home page to your top six coalition region HVA hazards.
How many Public Health Regions are within your coalition region?
*
Please check any basic pages/features you envision as part of your site.
*
Home
Contact Us
Useful Links
About Us
Directions
Resource Guide (Electronic Emergency Preparedness Guide)
News
Leadership Bio(s) with Photos
FAQs
Documents
Events (eCoalitions National Events Calendar added to your Website)
Become a Member
Privacy Policy (in footer)
Other Pages?
*
Please check any special features you envision as part of your site.
*
Search
Uploads
Video
Testimonials
Downloads
Image Gallary
Quotes
Map
Accept Online Payments (PayPal, Square)
Responsive website (formats to mobile devices)
Strategic National Stockpile (SNS) request form
Social networking icon links to Facebook, Twitter, email, etc.
Pet Reunification Form
Situational Awareness Message Board
Please check any database solutions you envision as part of your site.
*
Member Login/Register
Shopping Cart (accept credit cards)
Storefront
Products
RSS Feed for News
DonarBox (accept donations on your website)
Do you have a logo for your organization that you want to incorporate into your new website?
*
Yes
No
We need a logo
*
Indicates required field
Menu Location Preference
*
Top Left
Top Right
Top Middle
No Preference
The menu is how you navigate to the pages of your website.
Security
*
Choose One
Secure the entire website so that only Coalition members can access the site
Secure specific pages and leave balance of site open to the public
Unsure at this time
List Your Coalition Committees
*
Choose the documents to be added to the Documents page
*
Agenda
Minutes
Sign-in Sheets
Handouts
Choose all that apply.
Are there any colors you had in mind to incorporate into the site?
*
List up to 15 words (keywords for search engines) that are important to your Coalition.
*
When does your website need to be completed and made available to the public?
*
Comments
*
Submit Survey
