Website Design Request Form Personal

Page 1

Fields

Last Name *
First Name *
E-mail Address *
Telephone
Customer ID: *
How did you hear about us? *
Control Panel Username
Control Panel Password
Upload your logo
  • File
Domain Name (If you haven't registered your domain name yet, please compete the next line.)
Provide 3 Domain Names you want by priority-if first isn't available, we'll move to the next and on
Design # *
Provide a brief description of your website.
Can you provide content for use on the site? yes or no *
Can you provide photos for use on the site? yes or no *
Describe your target audience (people who would be most interested in your website)
Few words that describe how you want people to feel about your site. (exciting,creative,inspiring)
Special requests or instructions
Upload content file or add content for different areas below
  • File
Provide Content for area 1 (give detail instructions)
Provide Content for area 2 and 3 (give detail instructions)
Provide Content for area 4 and 5 (give detail instructions)
Provide Content for area 6 and 7 (give detail instructions)
Provide Content for area 7 and 8 (give detail instructions)
Any Special instructions about the contents or pages of your website
Your social media links (one per line)
Upload photo #1
  • File
Upload photo #2
  • File
Upload photo #3
  • File
Upload photo #4
  • File
Upload photo #5
  • File
Upload photo #6
  • File
Upload photo #7
  • File
Upload photo #8
  • File
Upload photo #9
  • File
Upload photo #10
  • File
Upload photo #11
  • File
Upload photo #12
  • File
Any Special instructions about the photos
Video embed code
Any Special instructions about the video
Any additional instructions, requests, or comments