Website Development Project Request Form

Please fill out the following Website Development Services Project Request Form as accurately and as completely as possible. This will allow us to really understand the goals and objectives of your organization, your specific request, and whether your organization aligns with the goals and objectives of our ministry.

Our desire is to provide you with the best ministry building services that we can, based upon the information you provide. We can then use the resources God has provided our ministry to help you meet your ministry goals and objectives. In doing so, both ministries may glorify God’s Kingdom and be good stewards of the gifts He has provided.

ALL information gathered by this questionnaire is confidential and will only be used internally by Harvest Media for your project.

If you have any questions concerning this questionnaire please contact Joe Goodale @ 520-790-1222. I will be delighted to answer or explain any questions you may have.

First and Last Name * Please enter your first and last name.

Decision Maker Are you the sole decision maker throughout the process of production? YesNo

If Not, Who is Decision Maker Who is the final decision maker for this project?

Organization Please enter the name of the organization you are requesting our services for.

Mailing Address 1 Please enter only the full Street or PO Box information in this box.

Mailing Address 2 Please enter any apartment numbers or suite numbers in this box.

City City associated with your mailing address.

State State associated with this mailing address.

Postal Code * Zip code or Postal code associated with this mailing address.

Email Address * Please provide us with a valid email address that we can communicate with you through. Your email information will be kept strickly confidential.

Phone Number * Please provide us with a valid daytime phone number.

Organization Description * Please briefly describe the nature of your organization's ministry.