Your Information:
Your First Name :
Your Last Name :
Email Address :
Your Company Or Organization:
Company/Organization:
Your Title:
Address :
City :
State/Prov :
Please Select:
Alabama
Alaska
Alberta
American Samoa
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
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None
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Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIP :
Phone:
Fax:
Which best describes your business, organization or project?
Please Select The Most Applicable:
Auto - Parts
Auto - Rental
Auto - Repair
Auto - Sales
Educational - Adult
Educational - Children
Entertainment - Arts
Entertainment - Broadcasting
Entertainment - Club
Entertainment - Dining
Entertainment - Sports
Event - Arts
Event - Other
Event - Political
Event - Sports
Event - Tradeshow
General Promotion
Government
Human Resources
Manufacturing
Non-Profit
Other
Political
Publishing
Retail - Appliances
Retail - Building Supplies
Retail - Clothing
Retail - Collectible
Retail - Floral
Retail - Furniture
Retail - General
Retail - Gifts
Retail - Grocery
Retail - Hardware
Retail - Jewelry
Retail - Music
Retail - Technology
Services - Builder
Services - Computer
Services - Dental
Services - Financial
Services - Home
Services - Insurance
Services - Internet
Services - ISP
Services - Lodging
Services - Marine
Services - Medical
Services - Other
Services - Promotion
Services - Real Estate
Services - Travel
Services - Veterinery
Services-Restaurant
Wholesale
Does your company or organization currently have a merchant account with a bank?
Yes
No
Not Sure
What is the size of your company or organization?
(Number of Employees):
Just Me
2 - 10
11 - 50
51 - 100
101 - 500
501 - 1,000
More Than 1,000
How does your company or organization currently connect to the Internet?
Please Choose One:
No Internet Connection
Modem Connection - One Phone Line
Modem Connection - Dedicated Phone Line
ISDN Line
Broadband - Cable Modem
DSL Connection
Frame Relay
T1 Or T3 Line
I don't know
Your Web Project:
What best describes your web site project? Check One:
If you already have a site, please enter your web site's URL:
How often will you need to make changes your site?
Please Select:
Daily
Weekly
Monthly
Quarterly
Yearly
Not very often
What best describes your own or your current staff's web skills?
Select The Most Appropriate:
Little Or No HTML or Graphics Knowledge
Used FrontPage, PageMill, Composer, Or GoLive
Fluent In HTML
Fluent In Perl, JavaScript, Or VB
Fluent In XML or SQL
Fluent In C++ Or Java
Which of the following apply to your web project? Check all that apply (at least one):
In the space below, please enter any questions or additional information about
you, your company, and any special requirements you project may need:
How did you find out about Cape.Com's web development services?
Select Any:
Barnstable Patriot
Yellow Pages
Cape Cod Voice
Cape Cod Times
Yellow Book
DSLreports.com
Internet Search
Cape Cod Online
Article In Newspaper
WQRC 99.9
WOMR 92.1
WCAI/WNAN - Cape & Islands NPR
WMVY 92.7
WATD 95.9
WPLM 99.1
Mashpee Commons
Falmouth Cable Television
Cape Cod Community Media Center (C3TV)
Cape Cod Technology Council
Cape Cod Chamber Of Commerce
Canal Region Chamber Of Commerce
Hyannis Chamber Of Commerce
Provincetown Chamber Of Commerce
Falmouth Chamber Of Commerce
Mashpee Chamber OF Commerce
South Shore Chamber of Commerce
Boch Center for the Performing Arts
Willowbend ProAm Golf Tournament
Cotuit Kettleers
New Bedford Blues Fest
Received Information in Mail
Friend Or Colleague
Current Cape.Com Customer
Former Cape.Com customer
Other
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