WEBSITE BUILD FORM

Office: 678.528.9628 | Mobile: 404.915.1456
Email: aj@adlcllc.com | Web: adlcllc.com

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Domain Information
Do you currently have a website?
Where is your current website hosted?
GoDaddy, Hostgator, Wix, Etc.
Do you currently own a domain?
Current Domain Name
Please tell us your domain name
Desired Domain Name
Please tell us the domain you would like to use. We will check if it's available for you..
Contact Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone Number

Area CodePhone Number
E-mail*
Legal Business Name*
This is the name that would be listed on your website, and used for Google schema.
Business Tag Line
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business Phone Number

Area CodePhone Number
Business Fax Number

Area CodePhone Number
Current Business Email
support@example.com
Website Questions
Business Sector/Category*
e.g. Italian Restaurant, Plumbing, Lawyer, Consultant, etc.
Please describe your Business in a few sentences.
Please give a brief overview of the company, what you do or produce?
What is the main purpose of this Website?

Explain your products and servicesBring in new clients to businessProvide your customers with information on a certain subjectDeliver news or calendar of eventsCreate a blog that addresses specific topics or interestSell a product or products onlineProvide support for current clientsOther
Is your business local or nationwide?
Business Hours:
Hours of operation i.e. Monday through Friday 8 AM to 5 PM
If you’re planning to sell online, are you set up to accept credit cards?

YesNo
If you’re planning to sell online, do you have any of the following merchant services setup for your business?

SquarePayPalStripeApple PayOther
Where do most of your customers come from?

InternetSocial MediaWord-of-mouthRadioBillboardsDirect MailCoupon BooksTVOther
What type of advertising do you currently do?

Social MediaPrint AdsRadioTVInternetBillboardsDirect MailCoupon BooksNoneOther
Who is your target audience?
Who will visit the site?
Do you require company email from us, or will you use existing email you already have setup?

YesNoOther
If someone were searching for your product/service on Google, what types of search terms (single words or phrases) might they use? Please list below all the possible search terms you can think of.
Do you have a color theme in mind? Is there a color I should stay away from when building your site?
What pages do you think your web site should have?

HomeAboutServicesGalleryContactPrivacy PolicyTerms & ConditionsFAQShippingReturn/RefundOther
Would you like a map so visitors can visit your business location?*
Upload your current logo?

Upload a File

Cancelof
Does Your Company have any Trade Certification logos?

Upload a File

Cancelof
What is your deadline for completing the site?

MonthDayYear
Social Media Information
Facebook URL
Enter the address of your Facebook profile or page URL
TikTok URL
Enter the address of your TikTok profile or page URL
Twitter URL
Enter the address of your Twitter profile or page URL
Google+
Enter the address of your Google+ profile or page URL
Instagram
Enter the address of your Instagram profile or page URL
YouTube
Enter the address of your YouTube profile or page URL
LinkedIn URL
Enter the address of your Linkedin profile or page URL
YELP
Enter the address of your yelp profile or page URL
Pinterest
Enter the address of your Pinterest profile or page URL
Vimeo
Enter the address of your Vimeo profile or page URL
Picasa
Enter the address of your Picasa profile or page URL
RSS URL
Enter the address of your RSS feed URL
Open TABLE
Enter Restaurant ID
OTHER NOTES AND COMMENTS
Should be Empty:

Domain Information

Contact Information

Website Questions

Social Media Information