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New Client Questionnaire – Startup
Prefix
Mr.
Mrs.
Ms.
Mx.
Miss
Dr.
Prof.
First Name
*
Middle Name
Last Name
*
Email Address
*
Phone
*
Street Address
*
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Australia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cabo Verde
Cayman Islands
Central African Republic
Chad
Chile
China, People's Republic of
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French South Territories
Gabon
Gambia
Georgia
Germany
Guernsey
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island And Mcdonald Island
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
Saint Helena
Saint Pierre & Miquelon
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich
Spain
Sri Lanka
Stateless Persons
Sudan
Sudan, South
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan, Republic of China
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
US Minor Outlying Islands
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
What services do you need?
*
Logo Creation
Website Development
Website Maintenance
Set-up of branded social media pages
Marketing (digital)
Email Marketing
Competitor Analysis
Content Creation (newsletter, press releases, etc.)
Other
What other services do you need?
*
Should your address appear on the website?
*
Yes
No
What is the official or legal name of your business, if applicable?
*
What is the primary nature of your business?
*
What is your key demographic or demographics at this time?
*
Describe your customers in a few key words or sentences.
*
What is your vision as a business?
*
Please provide any social media handles related to your business or you as a professional.
*
What are the immediate or short-term goals of your business?
*
What are the principal medium to longer-term goals of your business?
*
Please indicate your top 3 competitors.
*
Please indicate what you like or dislike about your competitor's marketing.
*
Do you have a specific or maximum budget in mind for what we offer? If so, please indicate.
*
Please describe what your expectations would be from a marketing strategy that I would help formulate for you/your business.
*
Do you have a domain for your business?
*
Yes
No
What is your preferred domain name (purchased or not - please indicate)?
*
What email address should be used on your website?
*
Do you need a hosted email (you@yourdomainname.com)?
*
Yes
No
How soon do you need the new website/marketing completed?
*
1-2 Months
2-3 Months
No definitive timeline right now
Please list the pages necessary for your website (e.g. Home, About, Contact Us)
*
Please type your Mission Statement and/or About Us (you can also attach a document to this form)
*
Do you have a color scheme? If not, what is your color preference for your website?
*
Do you need your logo designed/redesigned?
*
Yes
No
Do you need E-Commerce?
*
Yes
No
Not sure
Do you already have or need branded materials such as business cards, brochures, stationary?
*
I don’t need a branded materials
Business cards
Brochures
Other
What other branded materials do you need?
*
Additional comments - Anything else we need to know?
*
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