DIY Web Lab Questionnaire

Your Information

Name *

First

Last

Address Field

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Country *

Email Address *

Phone *

Business Name *

Do you have a registered domain?

Yes No

If Yes, what is your website URL

Business Stage *

Pre-startup (less than a year) Startup (1 -3 years) Growing (3-5 years) Established (Beyond 5 years)

Do currently have a published website?

Yes No, I need help with setting up

If Yes, Which website platform are you currently using?

WordPress Shopify Godaddy Square Space Wix Other

What would you like help with on your website? *

What other services are you interested in: (check all that apply) *

Please Specify