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Name: *
Company:
Phone: *
Fax:
E-mail: *
Address:
City:
State:
Zip:

How did you find out about us?

Referral

Promotional Material

Link

Search Engine

	Which:
	If other, please specify:
	Using which keywords:
	Other (please specify)

For which ADI service does your company need a quote:

1. Internet Development
2. Multimedia Design
3. Graphic Design
4. Desktop Publishing
5. Prepress & Printing

1. Internet Development (check all that apply)

	New website creation
	Existing website redesign
	Web hosting
	Internet access

Will you need to create a new company identity for use in your website?

	Yes
	No

How many pages do you estimate for your site?

What is the timeline for production of this website?

What is your budget for the site?

	$500 to $1000
	$1000 to $3000
	$3000 to $10,000
	$10,000 to $20,000
	$30,000 to $50,000
	$50,000 and over

What are the features you you wish to include on your site (check all relevant):

	Online commerce (credit card transactions)
	Generate new business leads
	Demonstrate products & services with audio/video
	Provide periodic updates

How often will you need the site to be updated?

2. Multimedia (answer all that apply)

	CD-ROM production
	Audio/visual presentation

Platform:

	PC
	Mac
	UNIX
	Multiplatform

Content Description:

Replication quantity:

Is there a need for custom animation/3D rendering?

	Yes
	No
	Don't know
	Animation/3D description:

Packaging provided in jewel cases:

	Yes
	No

How many colors in sleeve printing:

	1
	2
	3
	4
	Other:

3. Graphic design (answer all that apply)

	Logo design
	Illustration
	Signage
	Billboard
	Other (please describe):

Job description:

Number of colors:

	1
	2
	3
	4
	Other:

4. Desktop publishing (answer all that apply)

	Corporate identity package
	Magazine ad
	Annual report
	Brochure
	Other (please describe):

Description of project:

Size:

Number of colors:

	1
	2
	3
	4
	Other:

Stock:

Quantity:

5. Prepress and printing (answer all that apply)

	High-resolution scanning
	Film output
	Color proofing
	Printing
	Other (please describe):

Description of project:

Size:

Number of colors:

	1
	2
	3
	4
	Other:

Stock:

Quantity:

Do you have any additional comments
or other advertising/marketing needs that we can help you with?

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1500 N. University Drive, #204 / Coral Springs, FL 33071 / Tel: 954.575.8696 / Fax: 954.575.1981