Website Design Request
Fill out the form to request a design as completely as possible so I can get a good idea of how you want your website to look and perform. If you have any questions feel free to call or text me at 949-795-4721 or email me at firstname.lastname@example.org. Thanks! Jennifer
Company Name or Preferred Website Name
Address to use for the website
Street Address Line 2
State / Province
Postal / Zip Code
Phone Number to use for the website if different
Email to use for the website if different
What is the website/ company tagline or description?
Do you currently have a domain? If so please put domain name here
Who did you purchase domain through? (e.g godaddy, bluehost, etc)
Who is your Host Provider, or who do you plan to buy hosting from? (e.g godaddy, bluehost, etc)
Do you currently have hosting?
Do you currently have a logo?
If you have a logo please upload it here:
What colors do you prefer for your website?
Please tell me a little about your website, product or service:
What makes you different from your competitors?
What Keywords do you want your website to be optimized for?
What pages do you anticipate having? Please list pages here:
What social media do you want intergrated into your website (facebook business page, twitter, instgram, pinterest, google plus, etc)
What email do you want used for the website contact or newsletter notifications?
Do you need website setup to collect and be ready for newsletter distribution?
Describe your target audience:
Are there any websites that you like that you want your website to be similar to or that you like?
What elements do you like about those websites?
Are there any elements you really want on your website? (e.g. rotating images, social media integration, testimonials, map, events calender) ?
Do you want to be able to login to the backend of the website to make any edits or changes yourself?
How do you plan to market your website?
Are you planning on selling items on your website?
How many products are you planning on selling?
Do you have any product options?
How many categories are you going to have?
How are you handling tax?
What email do you want to use for order notifications?
How do you plan to accept payment for items you sell on your webisite (e.g, Paypal, Stripe, etc)?
Do you have a shipment system ( e.g. TruShip, Stamps, etc) ?
Which Shipment method(s) are you going to use (USPS, Fedex, UPS, etc)?
Anything else I should know?
Any Additional Services you may need?
Social Media Setup/ Marketing
Should be Empty: