Website Design Request
Fill out the form to request a design
Name
First Name
Last Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Company name and address
Type of Business
Please Select
Technology
Food
Beauty
Finance
Medical
Religious
Other__________________________________________________
Type of Website You Need?
Please Select
Personal
Retail
Educational
Sport
Food, Restaurant
Local Business
Small Business
Medium Business
Other__________________________________________________
**Single Webpage: Starting at $150(additional charges depend on the complexity and the amount of info to be added). **Website (2 pages and up): Starting at $250 (additional charges depend on the complexity and the amount of info to be added) All sites come with a free wix.com domain. If you would like a custom domain and the ability to accept payments, the cost of designing the website/webpage starts at $550 and is $324 each year after to keep those services.
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Single Webpage w/o custom domain(starting at $150)
Website (2 or more pages) w/o custom domain(starting at $250)
Single Webpage with Custom Domain(starting at $450)
Website (2 or more pages) with Custom Domain (starting at $550)
If you choose to go with a custom domain, what would you like your domain name to be...ex(mediadesigns.com) Please add as many choices as you want, just in case 1st choice is unavailable.
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Choose Items for the Navigation Bar
About
Contact us
Testimonials
Shop
Blog
Pricing
Other
More Items (home, about us, more, bio, events, reviews, contact us, etc) and what content would you like listed under each tab.
Brand Colors
Is there a particular font(s) you prefer
Please add any files, images, graphics, logos, etc here.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Additional Comments
$50 deposit required
*
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( X )
USD
Description
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
ACH Bank Transfer
Afterpay
After submitting the form, you will be redirected to Afterpay to complete the payment.
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