Dzignr Website Information Request Form

Name* This field is required.

First Name

Last Name

Email* This field is required.

example@example.com

Phone Number* This field is required.

Area Code

Phone Number

Business Name* This field is required.

Business Industry* This field is required.

Business Email* This field is required.To appear on the website.

example@example.com

Business Phone Number* This field is required.To appear on the website.

Area Code

Phone Number

Preferred Contact Method

Phone

iMessage

Other

Company Tag Line/Slogan

Does your business have a physical address or it is online?

PHYSICALONLINE

Business AddressLeave blank if there is no physical address.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Tell me about your brand/businessWhat does your business do? Who is your target audience etc.?

What Services/Products does your Company Provide? * This field is required.Please include a brief description of each as well as any associated pricing information.

What makes your business unique?Please include a brief description of each as well as any associated pricing information

Logo Image (.png format)If not readily available, please email it as soon as possible.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Browse Files

Please List Company Social Media Links BelowThis includes Instagram, Twitter, Tik Tok, etc.

Copy of Business PlanIf available.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Browse Files

Website URLPlease give an example of what you would like your website's URL to be

eg. companyname.com

Please describe the purpose of the website/why do you want one for your business?* This field is required.

Please advise CMS of Choice below.

Shopify

Wix

Wordpress

No preference

Do you need:* This field is required.Popular features/additions on a website.

Responsive Website (Adaptive resolution for mobile devices, tablets, etc.)

Search Engine Optimization Functionality (Ensuring high website ranking on search engines such as Google, Bing, Firefox etc.)

Google Analytics Functionality (Be able to track website traffic etc.)

Social Media Integration

Multi-language Support

Blogs

User Profiles

Job Application Process/Forms

Custom Images/Videos

Online Chat Features

ECommerce/Online Store

Appointment Feature

Other than the regular site pages/sections, are there any additional pages you may require?Regular site pages/sections include Home, About, Services and Contact.

YESNO

If yes, please advise:

Do you prefer:

Single Page (Scrolling) WebsiteMulti-Page Website

Please advise of any preferred website colors/fonts.

What is the intended launch date?

Date

Links to any existing website that you admire

Please upload a copy of Company PoliciesThis includes Privacy Policy, Shipping & Returns Policies and Terms & Conditions

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Browse Files

Dzignr Website Information Request Form