ACCS Client Information Sheet

Please complete the form below and email to Advantech and you'll be on your way to your own ACCS website.

Company Name:*
Contact Name:*
Contact Phone Number:*
Email Address:*
Target Date for Website Completion:
Mailing Address:*
Do you have a Current Domain name?	Yes No
If Yes: What is it?
If No: Do you have a preference?
Is your logo electronic? (postscript, jpg, gif)	Yes No
Is your content currently posted?	Yes No
If Yes: Would you like us to populate your ACCS site with current info for startup?
(extra charges at $49 per hour)	Yes No
What type of information do you want to present on your website?
What do you want to accomplish with your website?
What audience is your target market?