Website Change Request Form

Update My Website
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website URL*
Please describe requested changes including title of page(s) *
Are you adding a new page*
If yes, please include all photos, videos and text content for new page. *If you need me to write the content, please include applicable details. (fees apply)
Are you adding new events, classes/courses, workshops dates*

Yes, an eventYes, new class/course dateN/A
If applicable, please add event or class/course dates and details here
Optional
Are you adding photos/flyers?*
Please attach new photos
Attach Photo(s)

Browse Files

Cancelof
Will this photo replace any existing photos?*
Please advise which photo to replace in comment box below
Are you adding new paragraph text? Please paste new text below. Please include the location on website you would like this text added?*
Are you adding or modifying your products?*
E-Commerce Sites Ony
Are you including external links?*
Please copy and paste links below
External Links
Please include entire URL
My Requested Updates
prevnext( X )
Adding 1-6 new photos/flyers (photo description text included up to 75 words)$25.00
Make sure all photos are attached

Add New Text/Content (up to 500 words)$25.00
Please make sure you've included the pre-written text and requested location on website

Content Writing up to 300 words$20.00
Please include all applicable details to be included in the paragraph(s)

Adding/Modifying Products/Services/Events/Courses, etc$35.00

Add New Page $65.00
Please make sure you've included all applicable details

Other Modifications $25.00
This includes external links to other websites, video, pop-ups, etc.

Total $0.00
I certify that I have requested the above changes on page(s) Enter title of page(s) . Signature Date
Should be Empty:

Update My Website