Full Name
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First Name
Last Name
E-mail
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Phone Number
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Area Code
Phone Number
Company Name
Do you currently have a hosting plan?
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Please Select
Yes
No
If no, please sign up with our hosting company before receiving your free custom website.
Domain Name
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Type of Web Design Service
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Please Select
Redesign and/or modify a template
Design a new website from scratch
Website Category
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Look under "Template Categories" on the right sidebar.
Name of template downloaded
Main color theme of your website
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Red
Purple
Green
Blue
Yellow
Orange
Gray
Black
White
Do you have a logo?
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Yes
No
Do you have any pictures to put on your website?
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No. I don't have any pictures to put on my site.
Yes. I have 5 or less pictures to put on my site.
Yes. I have between 5 and 10 pictures to put on my site.
Yes. I have more than 10 pictures (between 10 and 20) to put on my site.
Yes. I have more than 20 pictures to put on my site.
What type of products / services do you offer?
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Your Target Customers
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Who do you sell your products/services to?
Keywords (Please use commas (,) to separate key words and phrases)
What search engine keywords do you want your visitors to use to find your site?
Website Menu and Pages
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Home
About
Services / Product
Contact Us
Others
Home Page Content
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About Page Content
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Services / Product Page Content
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Contact Us Page Content
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Other Pages Content
Please name the pages and provide the content you want to be on these pages
Special Instructions
Any further information that can help us design a website to your preferences
Additional Services
Banner Design
Landing Page Design
Advertisement Management
SEO
Video
Analytics
Facebook Landing Page Design
Mobile Website Design
Do you have a PayPal or Stripe account?
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Yes
No
Upload any files (such as logo, images, marketing materials or catalogs, etc.) that might be helpful to your website design
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Project Deadline
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Year
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Month
Day
Date
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