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Request for Quote

Full Name:
Business Name:
Phone:
Email Address:
Do you own a domain:	Yes No
if yes, what is it if no, what domain would you like (based upon availability)	see godaddy for domain availability
Please enter up to 5 email accounts and desired passwords to be setup at your domain.
Email Address: Password:
Email Address: Password:
Email Address: Password:
Email Address: Password:
Email Address: Password:
Email Address: Password:
Payment Option:	Credit Card or PayPal Check or Money Order
Payment Plan:	Bill me monthly Bill me yearly (free month!)
Package Options:	Basic Package ($150 setup - $35 monthly) Plus (select any custom items you are interested in - this DOES NOT obligate you to purchase these options): Mailing List Manager ($5) Newsletter Manager ($10) Glossary ($5) Shipping API Integration ($5) Payment Gateway Upgrade ($5) Up/Cross Sell Products ($5) Affiliate Program ($10) Ebay/Froogle Integration ($7) Ebay/Froogle Integration ($7) Business/Resource Directory ($7) Live Chat (varies by service) Classified Ads ($5) FAQ Manager ($5) Customer Login ($5) Survey Posting ($5) Custom Forms (hourly fee)
Layout Option: graphic options	Sample One Sample Two Sample Three Sample Four Sample Five Sample Six Template Upgrade Custom Design I have my own design
Website Colors: websafe colors	describe your desired color scheme
Payment Processor:	Free PayPal PayPal Pro ($20 monthly fee to PayPal) Authorize.Net (fees vary, see Authorize.Net) Verisign (fees vary, see Verisign) Undecided
Shipping Calculations:	Free Shipping Per Product Based on Order Amount Total USPS, UPS or FedEx Lookup ($50 setup/$5 per month) Undecided
Your Product(s): tell us a little about your product(s)
Your Business: tell us a little about your business
Notes:

Email: info@originalwebsolutions.com

Web: www.originalwebsolutions.com

Phone: 1.541.521.1878

Fax: 1.541-345-2082

Mailing Address:
1200 High St., Ste 110
Eugene, OR 97401

Offering custom, affordable web design to businesses and organizations in Eugene and surrounding Oregon communities since 2000!

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