Get started with your app
Name
*
First Name
Last Name
Confirm your Email
*
example@example.com
Phone Number
*
Mobile
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
What is your Website
if applicable
What is your Instagram username
if applicable
What is your Twitter username
if applicable
What is your Facebook
if applicable
Business Address if different
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
App information
App Name
*
name your app
What features would you like to see on your app?
View a list of
features.
Choose at least 4 feat.
Appointments
Coupon
Calendar
Video
Discount
SmartAds
Newswall
Loyalty Card
Fan-wall
Club Card
Audio
Call/GPS
Radio
Choose at least 3 Colors that best represent your brand.
Red
White
Blue
Black
Yellow
Grey
Green
Purple
Pink
Orange
Tan
Brown
Teal
Turquoise
Hot Pink
Other
Are you using a booking system?
If applicable please provide your booking link.
Add any additional information you would like us to know here.
I understand that
By filling out this form you agree to pay a non-refundable $250 fee to get a preview of your app. Efexxapps will build you a preview of your app based on the information you have provided in this form. This process will take approximately 3 business days. Feel free to contact us via email at admin@efexx.com
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