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Website Request Form
Name (First, Last)
Phone and Email
Street Address
Street Address Line 2
City
Region/State/Province
Postal / Zip code
Country
Select Service(s)
Design Website
Web Maintenance
Business Card
Flyer
Label
(1) Company Name, (2) Type of Business, (3) Current website URL or you need a new domain, (4) Describe your target audience.
Describe your request - include main objective(s) or goal(s)
(1) Provide the Page(s) for site. (Eg. Home, Appointment, About, Contact, Events, Shop, News, etc). (2) Call-to-actions: first action you want your customers to do? (Eg. call, subscribe, visit site location, Donate, Shop online, etc)
(1) What are your theme color(s)? (2) Prefer bold or light colors? (3) if any, provide preffered font(s)
Do you have a specific idea or an example of how you want your webesite to look? If so provide.
Do you have attachment(s) to upload on website. Eg. Videos, images, documents?
*
Yes
No
Submit Form
Thank you! We’ll be in touch.
Website Requst Form
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