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Brainwrap Contact Information
Telephone:
248 545 7570
 Mailing Address:
Fax:
509 472 4284
 Brainwrap Web Design
2777 Griffith
Berkley, MI 48072
E-Mail:
AIM:
 BrainwrapWeb
Service Information Request Form

Brainwrap offers a variety of services in four major areas: Website Design/Development; Website Hosting/Domain Name Services; Digital Video/Media Transfer/Editing; and Macintosh Training/Support. Feel free to fill out whatever sections of the form below are appropriate to your needs. Your name, email address, and a phone number are required in order for Brainwrap to contact you; everything else is optional.

IMPORTANT: Brainwrap will NOT share your information with any third-parties without your consent!

GENERAL CONTACT INFORMATION
Your Name:
Street Address:
Title / Department:
Bldg / Suite / Apt:
Company:
City:
Email Address:
State/Province:
Full Phone Number:
 ext.
Zip / Postal Code:
Full Alternate Phone:
 ext.
Country:
Full Fax Number:
ICQ / AIM:
Were you referred to us? If so, by whom?
Name of Contact (if not yourself):
WEBSITE DESIGN / DEVELOPMENT
Is this a new website or a revamp of an current site?
New Website
Revamp of Existing Website
If this is a revamp of an existing website,
please provide the current site address:
How large do you estimate the website to be?
(Smaller sites can be expanded at any time)
Which of the following website deveopment-related features are you interested in?
(Choose all which apply)
Visitor Feedback Form
Searchable Databases
Flash® Animation
Message Board/Guestbook
Original Logo Design
METAtag/Key Word Optimization
Site Search
Search Engine Submissions
Video Clips on website
Mailing List
Blog/Content
Management System
Domain Name Reg./Transfer
(see below)
Web Hosting
(for new sites or if you're unsatisfied with your existing hosting service; see below)
E-Commerce
(Shopping Cart, SSL Server, Web-based Store Admin, etc; may require new hosting, see below)
Web Development-related comments, questions, specific requests, etc:
WEBSITE HOSTING / DOMAIN NAME SERVICES
Basic
Standard
Advanced
Ultra
Register New Domain
Transfer Existing Domain
Renew Existing Domain
Do you have one or more specific domain names in mind for your site?
List domains in order of preference; if more than one is available, we can also have others auto-point to the main one.
End your choices with .com, .net, .org, .biz, info or .us
eg: www.yourdomain.com
2. www.
1. www.
3. www.
Hosting-related comments, questions, specific requests, etc.:
DIGITAL VIDEO / AUDIO / ETC. SERVICES
Which of the following digital media-related services are you seeking?
(Choose all which apply; many of these overlap each other)
Convert Analog (VHS, Mini-VHS) or Mini-DV Videotape Footage to Digital (DVD-ROM)
Digital Video Editing (cut out unwanted footage; add titles, transitions/effects, audio/music, chapters, etc.)
Convert Photos to DVD Slideshows (physical prints or digital photos; add music/effects, etc.)
Other (Describe Below)
Digital Media-related comments, questions, specific requests, etc.:
MACINTOSH TRAINING / SUPPORT
Which of the following Mac Training/Support services are you seeking?
(Choose all which apply; many of these overlap each other)
General Macintosh Use (Operating System, basic functions)
Internet / Web / Email Basics, Tips & Tricks
Digital Media Management (iLife: iMovie, iDVD, iTunes, iPhoto, GarageBand)
Switching from Windows to Macintosh (File Transfers, Task Equivalents, etc.)
Other (Describe Below)
What kind of Mac do you currently have?
What version of the Mac OS are you using?
What's your current (or intended) "Platform Status"?
Macintosh Training/Support-related comments, questions, specific requests, etc.:
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