Username

E-mail

First Name:

Last Name:

Website:

Blog URL for this design job:

Phone number:

Please list any free WordPress themes that you like, or the theme that is closest to what you want. :

What work do you need done or what package do you want?:

Tune-up ($150/$175)
Custom Blog ($400)
Blogsite ($500)
Other

How many columns do you want for your blog? :

1-column
2-column
3-column

How wide (in pixels) will you be posting your images at? :

Desired overall width of blog (width of columns combined) in pixels. :

Preferred background color :

Preferred color(s) of center column(s) :

Preferred font family (must be web safe):

Preferred body text color (hex code #):

Preferred color of Post Titles (hex code #) :

Preferred color of text links within posts (hex code #) :

Preferred HOVER color of text within posts (hex code #) :

Please indicate any additional color guidelines. :

What type of header banner would you like? :

Static banner (one image only)
Flash Banner (unlimited slideshow format)
Rotating Banner (different banner with every page refresh)

Would you like your static logo placed above or below your banner?:

above
below
built-into flash banner

Basic plugins you would like installed:

SEO plugins
Statistics plugin
Subscription form
Blog polling
other

If you chose OTHER, please indicate other plugins you would like installed here:

Deluxe customizations and scripts you would like installed:

Contact form
Flash slideshow header
Scrolling comment box
Custom background wallpaper tile design
Post Title or Separator graphic
Typepad posts imported and images transferred
Enhanced footer with additional widgets (i.e. recent posts
search
etc..)

Additional design requirements :

A password will be e-mailed to you.