Website Intake Form

1
Name* This field is required.
First Name
Last Name
2
Company Name* This field is required.
3
Email* This field is required.
example@example.com
Email Verified
Confirm Email
Email Verified
The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification
••••
Didn't receive verification code?or
Receiving the email may take a few minutes, thank you for your patience!
4
What is your website URL?* This field is required.Enter your website address. If the website doesn't exist yet, enter the domain you want to use.
5
What is the purpose of your website?* This field is required.Will this be a transactional e-commerce site? A informational site? A blog?
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6
Do you have branding or colors that you would like us to incorporate in the design?* This field is required.
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7
Who do you anticipate will be viewing/purchasing from your website? * This field is required.
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8
Do you have any existing copy that you would like to use? * This field is required.
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Do you have existing images that you would like to include?* This field is required.
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10
What key points would you like to include in your website?* This field is required.
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11
How is {companyName} different from others in the industry? * This field is required.
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12
What are your unique selling points if applicable? * This field is required.
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Would you like to include a link to a lead form or just a phone number? * This field is required.
14
Do you have any examples of websites that you like?* This field is required.
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15
Do you have any examples of websites that you dislike?* This field is required.
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16
Please let us know if there is anything else that you think would be beneficial for us to include in designing your website.
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