Website Intake Form

Website Intake Form
Customer Business Name
Customer Project Manager
Project Manager Email
Office Phone

Area Code Phone Number
Text Phone

Area Code Phone Number

Public Information on the Website:

This information will be used for your customers to find you.
Business / Organization Name:
Physical Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Main Phone Number:

Area Code Phone Number
Support or Contact Email:
This email will not be shown on website, unless you request it. This will be the email to which Contact Page submissions are sent.
Other Public Contact Information:

Website Domain Information:

The following information is for our developer access only and is kept private.
Domain Status:

Currently Being Used Not Active Not Sure Where It Is Don't Have One
Current Website Domain Name:
Domain Registrar:
Where do you have your domain name registered? For example, Godaddy, etc.
Registrar User Name:
This information is needed to access and then point your domain to our server.
Registrar Password:
We will contact you to get this cleared up for you.
Do You Want to Use a New Domain Name?

No Yes
Suggested New Domain Name:
We will purchase a new one for you at no extra cost, after checking with you about it.

Desired Design Look and Feel:

This information helps us to create your site to look unique and branded to you and your audience.
Target Audience:
Describe the demographics of your audience; for example, young professionals; sports enthusiasts; veterans; vegetarians; etc.
Color schemes:
At least 2 main colors. Provide exact color codes if you have.
General Look and Feel:
Other Websites that you would like to emulate:
DON'T OVERLOOK THIS. It can really help us to know what kind of website looks you like.
Social Media Integration

Only include the social media pages you want to include. If you have none, leave blank.
Facebook Page
Twitter Page
Youtube Page
Instagram Page
LinkedIn Page

Content for Website

This stuff is absolutely critical to get started and to build your website project.

Our basic 4 page website contains (1) a Home Page; (2) a Contact Page with email form, which includes contact information; (3) an About page with your company images and text; (4) a Final Page with Services, Menus, Leadership Team, etc. We have flexibility in arranging the content to suit your purposes. If you need, we will include a Privacy Policy and/or Terms and Conditions page, for no extra cost.
TIMING IS OF THE ESSENCE

As soon as possible, please send images, logos, text docs, menus, videos, flyers. Attach Here.
ATTACH files HERE

Upload Images, Docs, Menus

Cancel of
Do you want a LOGO designed or redesigned by us?

Yes No
Please UPLOAD your current LOGO image:
Logo Image HERE

Upload Logo
Please send the largest image of your logo available. Cancel of
Logo ideas and suggestions:
You may choose three (3) images at our image site: https://stock.adobe.com/ for FREE.

Search with your keyword + "logo" to find appropriate images.

Enter the image #
Adobe Stock Image Number(s):
You may choose three (3) images at our image site: https://stock.adobe.com/ for FREE.

Use search term, eg. "pizza" "chinese food" "mexican food" "logo" or "icon" etc.

Then, give us the image #
Adobe Stock Image Number(s):
We will purchase 3 images for you to be included on your website. Additional images can be requested for a charge of $10 for each additional image, which provides you access to use them on your site or on promotional printed material. We retain all licensed rights.
Should be Empty: