WRU - Website Design Form

embedded in https://websitesrus.co.za/websiteinformation
[A Division of Dinesa Marketing(Pty)Ltd]
WEBSITE DESIGN INFORMATION FORM

Please Complete our Website design information form, to give us a better understanding of what You would like
Note: Should there be any questions that you don't know the answer to yet, you can just leave it blank.
Name of your buisness*
Your name (required)*

First NameLast Name
Your email (required)*
Phone Number*
Landline Phone Number
Do you want your business address listed on your website?

YesNo
Address

Street Address

Street Address Line 2

CityProvince

Postal Code
In short, what is your business & website about? (required)*
Do you have a Facebook Business Page?*

YESNO
What is the link to your Facebook Page
Do you currently have a registered domain name (registered name of your website)

YESNOI am not sure
What is your current website adress?
What name would you like for your website?
Optional Website Addresses (Choose 3)
Do you already have a logo or branded material such as business cards, stationary, etc?

YesNo
Please upload any images and logos you currently have for use on your website/stationary/social media

Browse Files

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Do you need email adresses?

YesNo
List The Email Addresses Required
Current Website

(If You Have One)
With whom do you currently host your website?
Will the existing website content be used?
Your New SiteThe importance of first impression is paramount. How should visitors describe your new site? (Examples: modern, user friendly, bold, corporate, fun, forward thinking, innovative, bright, calming, elegant, clean, minimal, etc.)
What kinds of images best reflect your business? (Examples: business images, product images, industry, nature, etc)
Do you have a color scheme? If not, what is your color preference?
Additional comments
If you are ready to proceed and want us to start creating your website, please pay the deposit into the following account:

Dinesa Marketing
First National Bank (FNB)
Account No: 628 2095 5766
Branch code: 250 655
Ref: Your business name
Which website package would you like?

Single Page Website R399Scroller Website R499Business Website From R2499Corporate Website From R4499E-Commerce Website From R3499JANUARY SPECIAL R299
Deposit required: (Single Page Website) R300
Deposit required: (Scroller Website) R400
Deposit required: (Business Website) R2000
Deposit required: (Corporate Website) R4000
Deposit required: (E-Commerce Website) R3000
Please upload the proof of payment

Browse Files

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Should be Empty:

WEBSITE DESIGN INFORMATION FORM

Current Website