Please fill in the form below to have a customer service representative contact you for a free consultation.
Customer Information
 *Name: 
  Business Name:  
 *Email: 
  Street Address:  
 City: 
  Province:  
  Postal Code:  
 *Phone: 
Design Information
  Is this a new site or a re-design of your current website? (Please check one below):  
  New Site              Re-design  
 Do You Have a domain Name? If yes, please provide the Domain URL below: 
  (www.yoursite.com)   
  If no, would you like Mighty Community to research one for you?  
  Yes              No

A domain name should be easy for customers to remember, short and simple. Domain names to search for:

Preferred Domain Name
Second Choice
Third Choice

 
  What is your budget?

Economy Package - I'm on a tight budget and want the Best Value for the least dollars
Value Package - I want my website to present a better image without adding extra features.
Premium Package - I'm willing to pay a bit extra for added features to ensure I have a professional site that reflects my business image
I know exactly how much I want to invest in a website $  		 
Website Content
 
Which of the following features would you like on your website. Click all that apply.
 Product Photos/Inventory  Company History/Policies
 Daily/Weekly Specials  Credit Application
 Menu  Links to Suppliers
 Photo Gallery  Customer Testimonials
 Staff Bios/Photos  Contact Form
 
  List any other features:
 
Additional Services
 
 E-Commerce  Search Engine Optimization
 Guestbook  Flash Animation
 Blog  Logo Design
 Customized Graphics  Sound Clips
 
  List any other options:
 
Submit Request for Quotation
 If you are done with your request form, please submit your information and a representative will contact you. 
            
2485 King George Highway, Comp 21, Suite 105 Miramichi, NB E1V 6W6
Phone: 506-773-7668 Fax: 506-778-9511
Email: sammy@mightycommunity.com