upton(a)way media - Customer Information

[ CONTACT ]

please complete the information below to allow us to begin the design of your website. Please send any logos or photos [please send as .gif, .jpg, .tif, .eps or .bmp] and editorial [please send as .txt, .doc or .xls] via email to sitebuild@uptonaway.co.uk.

YOUR DETAILS

Name*

Email*

Telephone*

DESIGN REQUIREMENTS

Main colour*

Second colour*

Third colour*

Menu layout*

Contact info for website*

[address] [postcode] [telephone] [fax]

ADDITIONAL INFORMATION

Comments

[ * all fields required ]