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1275 Paterson Plank Road Secaucus, NJ 07094
201-392-8266 
info@rivieratechnj.com
What more information and set up a meeting?
Please fill out the below form and click on the submit button
Web Site Start up  Form
Name:
Company:
Address:
Phone:
Business Type

Email:
Do you currently have a we site and want us to re design it?     (if yes ,please answer the nest 2 questions)
1. Hosting Company Name:
2. Domain Name: www.
Do you have a logo?
Do you have pictures?
Do you have content already prepared, such as information about your company, mission statement, material related to your products and / or services?
What are you looking for?
How many web pages do you need?
Do you need to make frequent changes (daily, weekly, monthly)?
YesNo
YesNo
YesNo
1 -3
4 - 7
8 plus
Unsure
YesNo