Virtual Interview - eCommerce Websites

Your company success is important to us, and we know your time is valuable.  We want to make our meeting with you as productive as possible. 

Please complete the questions below as completely as you can, to help us get to know your needs better.

Regards,

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Title DR Dr. MISS MR MRS MS

First Name *

Last Name *

Email Address *

Work Phone Number *

Work Address *

City *

State *

Zipcode/Postcode *

Country * -- Select Country -- AFGHANISTAN ALAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA 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 DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLANDS COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA CÔTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTENEGRO MONTSERRAT 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 PALESTINIAN TERRITORY, OCCUPIED PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT BARTHÉLEMY SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SERBIA AND MONTENEGRO SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES UNITED STATES MINOR OUTLYING ISLANDS URUGUAY UZBEKISTAN VANUATU VENEZUELA VIETNAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE

Company *

Preferred Date for Completion and Launch

Target Market/s

What is your projected rate of business growth for the next 12 months? ( % of gross revenues)

What is your projected rate of business growth for the next 5 years? ( % of gross revenues)

Preferred Company Email addresses, if known (eg: info@mycompany.com, sales@mycompany.com):

Company Mission Statement (60 words or less)

Product Item Numbers (select one) I would like JORD to provide default product item numbers My company has existing product item numbers. Use these numbers.

My company has or can provide the following (check all that apply): High-resolution (300dpi) product photography Catalog product descriptions Catalog product name Catalog product price

Company Tagline

What are the expected price ranges of your catalog items? (select all that apply) -- Please select -- $1.00 - $50.00 $50.00 - $100.00 $100.00 - 500.00 $500.00 - $1000.

Website Customer Service Phone (if different from work phone above)

I would like JORD to register a domain name in my behalf Yes No

Select number of initial products in catalog (check one) 1-50 51-100 101-150 151-200 201-499 500+

Company and Catalog Details (check all that apply) Have Company Logo Need Company Logo Have Company Logo but it needs work Have Company Tagline Need Company Tagline Have domain already registered for this site Need to register a domain for this site Have additional sub-domains to point to site Would like to purchase additional sub-domains to point to this site. Have all product photos for initial launch Have some product photos for initial launch Need product photos (extra charges apply - please inquire) Have a merchant account for online sales Products require shipping Have shipping vendor accounts Need shipping vendor accounts All or some products are downloads

Enter principal domain name if registered (eg: mydomain.com)

List principal domains preferred (in order of preference), if no principal domain is currently registered.

Select features you are interested in (check all that apply - some features require additional fees) 1 Blog Additional Blogs Email Marketing Campaign - up to 10000 sends per month included Custom HTML Newsletter Template (to echo your website design) Newsletter Signup Form Secure Zones Discussion Forum in secure zone with login Discussion Forum unsecured - no login Announcements/Events Module Searchable FAQ Rotator Ads (selling ad space on your website) Additional Forms Events Calendar SMS Messaging Campaign - up to 10 per month Custom Web App Device-specific version - please inquire Affiliate Sales Program Additional Users

Social Media - Current Accounts Facebook Business Page Twitter Linked In Other

Comments or Questions

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