W LUXER TECHNOLOGIES
WEBSITE DEVELOPMENT INTAKE FORM
Information Needed for Your Website:
Full Name
*
First Name
Last Name
Best Phone Number to Contact
Please enter the best phone number to get in contact with you
Format: (000) 000-0000.
Best Email to Contact
Please enter the best email to get in contact with you
Your Business Information
Business Name
What is the name of your business?
Business Slogan/ Catch Phrase (Optional)
Business Address (Optional)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone # (Optional)
Format: (000) 000-0000.
Business Email (Optional)
example@example.com
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Business Brand Mission Statement
Briefly describe your business (the brand or mission statement). (1 paragraph at minimum)
Your Website Services
What services would you like to see displayed on your website?
Provide a full list (if any) of services that your business provides, followed by a brief one sentence description of each service.
Example: (Professional development- Enhance skills and knowledge to help both individuals and organizations stay competitive.)
Operating Business Hours
List the operating hours of your business below
Website/Company Awards or Certifications (Optional)
List any certifications and/or distinguishing awards that you or you business holds that you would like to add to your site.
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Your Website Features
What type of features would you like to have for your website?
Rows
Would Like
Live Chat
Schedule/Book Appointments
Blog
Online Store/Purchasing
Other
If 'Other' was selected, please describe the feature you would want to include.
What Kind of Website Design Examples Do You Like?
Please provide 1-3 websites that you like in terms of their design that align closely to what you're going for. (Design, animation, styling, content, etc.)
Rows
Link to Website
What you like about the site
Website Example 1
Website Example 2
Website Example 3
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Social Media Links (Optional)
Fill this section out only if you have or need any social media links for your business
Select any social media accounts that you have or need for your business.
Rows
Have
Need
Facebook
Twitter (X)
Instagram
LinkedIn
Pinterest
Other
Site Pictures/ Media
Upload any relevant attachments that you would deem necessary to be displayed on the website, whether it be Logos, Designs, Staff Photos, etc
Browse Files
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