Name
 

Email
 

Secondary Email
 

Mobile Phone
 

Home Phone
 

Other Daytime Phone
 

Mailing Address
 

City, State, Zip
 ,    

Please note: It is often necessary over the course of site development that we have specific usernames/passwords, as it is generally easier for us to do something than try to walk you through it. While we ask for a variety of usernames/passwords, we do not require that you include any of them if you do not feel comfortable doing so. This information you provide will only be available to Liz and limited members of her team. The purpose for each request is provided with the request. We recommend that you change any password you provide to us to one that you do not use for other things. (In other words, if your twitter password is the same as the password you use for your online banking or for your email, please change the twitter password prior to submitting it!)

Name
 

Site Purpose

Website or Domain Name
 

Where is Domain Registered?
 

Domain Registration Username?
 
Note: If your site will be hosted through Bemis Promotions, the domain name servers at your registrar will need to be changed to point to our servers.

Domain Registration Password?
 

Where is Current Site Hosted?
 

Site Host Username?
 
Note: If your site will be hosted in this location, we will need access to upload the files that make your site run.

Site Host Password?
 

Twitter Username
 
Note: If your site is to have a twitter feed, we will need to access your twitter account to set permissions between your site and Twitter.

Twitter Password
 

Top 5 Sites (and what you like about them!)

1)  

2)  

3)  

4)  

5)  

Please indicate what features you would like as part of your site:
 Bio or About
 Frequently Asked Questions
 Contact Form
 Press or Media Page
 Latest News Archive
 Appearances
 Books Index
 Individual Book Pages
 Printable Book List
 Newsletter
 Links
 Resources
 Articles
 Awards
 Photo Album
 Contest
 Members Only
 Blog
 Twitter Feed
 Facebook Feed

Please list any other features you may need or anything else we should know:

Your Name
 

Please indicate any services will you might want or need in the next year.
(Please check all that are applicable, even if you’ve already spoken to us about them!)

 Site Refresh/Redesign
 New Site for a different penname/specific campaign/other purpose
 Maintenance Package
 Newsletter
 Bookmarks
 Business Cards
 Post Cards
 Promotional Mailing
 Brochure
 Other print materials
 Video
 Other
Other:  

Do you currently have a maintenance package?
 Yes No

If no, what are your reasons for declining a maintenance package?
 Too expensive
 I rarely update my site
 I update my site myself
 Other
Other:  

How are we doing?

In order that we may better serve you and help you achieve your goals in the future,
please give us a benchmark of your experiences, indicating your overall satisfaction with
the following Bemis Promotions services:

Website Design:

 My site is pure perfection. It is everything I could ever hope it would be.
 My site is great. It visually displays what I do well.
 My site is fine. It may not be the best thing out there, but it suits my needs.
 I have serious issues with the design of my site.
 I do not have a Bemis Promotions Website.

Website Execution:

 My site has every feature I could possibly every want… and more
 My site has most of the features I need.
 My site needs some work.
 I haven’t looked at my site in months. And because of the lack of features, neither has anyone else.
 I do not have a Bemis Promotions Website

Website Cost:

 My site was so inexpensive, I felt like I was getting away with something.
 My site was very reasonably priced.
 The price of my site seems commensurate with the market.
 My site was overpriced.
 I do not have a Bemis Promotions Website

Website Maintenance:

 My site has been well maintained. I couldn’t be happier.
 Updates to my site happen within a reasonable amount of time.
 Updates have occasionally been tardy.
 I’ve given up on my updates ever being completed.
 I do not have a Bemis Promotions Site, or I maintain my site myself.

Print Material Design: (Bookmarks/Post Cards/Business Cards/Brochures)

 My Print Materials were beautifully executed.
 My Print Materials were capably completed.
 My Print Materials are fine.
 I will never use Bemis Promotions for print materials again.
 I have never purchased Print Materials from Bemis Promotions.

Print Material Cost:

 My print materials were so inexpensive, I felt like I was getting away with something.
 My print materials were very reasonably priced.
 The price of my print materials seems commensurate with the market.
 My print materials were overpriced.
 I have never purchased Print Materials from Bemis Promotions.

Customer Service:

 I’ve been very pleased by Bemis Promotions’ customer service.
 I’m generally satisfied by Bemis Promotions’ customer service.
 I’ve had a couple of problems with Bemis Promotions’ customer service.
 Bemis Promotions has no discernible sense of customer service.

What else are we doing well?

In what other areas do you feel we need improvement?

How likely would you be to recommend your experience with Bemis Promotions
to a friend or colleague?

 I Have and Do All the Time!
 Very likely
 Somewhat likely
 Not likely

Do you have any friends or colleagues who could benefit from our services?
If so, we’d love to talk to them. (Please provide a name and an email address.)

Anything else we should know?