The Web Surgery - Web Design UK


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London: 020 8144 6540

Lancashire: 01282 570 880


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    Your Full Name

    Your Tel or Mobile Number

    Your Email

    Name of Company or Brand

    Which Of The Following Are You Looking For?

    Website Design

    If you've agreed to a Web Design Package please indicate which one:

    Start Up: 3 page website
    Small Business: 6 page website
    Small Business Pro: 9 page website
    Business Pro: 15 page website
    eShop: Basic
    eShop: Pro

    What do you want the website to offer people, what are the main messages, concepts, ideas?

    Two Colours That You Would Like Your Website To Have?

    Tell us at least 3 websites that you like and a brief description as to why?

    Logo For Website

    Have a logo
    Want a logo designing (request further information - additional costs apply)

    Email Accounts Wanted

    Free webmail email
    Connect To Email Supplier - Gmail, Hotmail, Microsoft Outlook, etc

    What Functions Would You Like Your Website To Have? (Please see below the number of functionalities allowed for each website package)

    Start Up: 2
    Small Business: 4
    Small Business Pro: 6
    Business Pro: 8
    eShop: 10
    eLearning: 10

    Front Page Image - Static
    Fornt Page Images Rotating
    Gallery Of Images
    Social Media Icons
    Live Social Media Feeds
    Customer Login
    Book Online
    Online Shop
    Podcast / Audio
    Contact Form
    Location Map
    Install SEO (Search Engine Optimisation) basic pack
    Ecommerce shop using Paypal
    Ecommerce shop using Credit Card Payment

    Anything Else You Would Like Us To Know? (Such as login details for your domain, hosting, FTP etc)

    Please click the I'm not a robot box below and then send