| Name
|
|
| Company
|
|
| Phone
|
|
| Email
Address |
|
| Do
you want to be contacted by a representative of IROM
Solutions? |
Yes
No |
| Do
you currently have a Website? |
Yes
No |
|
How
would you classify the complexity of your application?
|
Simple
Intermediate
Complex
Unknown |
|
Which
of the following best describes what your looking
for? |
Internet Marketing
Website Development
Search Engine Submission
Web Hosting
Domain Name Registration
Search Engine Optimization |
|
What
is your implementation time-frame? |
Immediate
Less than 30 Days
30 - 90 Days
Greater than 90 days
Undetermined |
|
How
did you learn about IROM Solutions |
Internet Search Engine
Internet Advertisement
Trade Magazine
Newspaper
Friend or Colleague
Other |
A
brief description of your needs |
|