CUSTOMIZED WEBSITE ORDER FORM
Contact Name
*
Company Name
City and State
*
Phone
*
Email Address
*
How would you prefer to be contacted?
Email
Phone
Either
If you currently have a website, please supply the website address here
Will you need a domain name registered for your website?
*
Yes
No
List at least 3 domain names you would like to register by 1st, 2nd and 3rd choice preference::
Will you need your website hosted?
*
Yes
No
Approximate number of pages you will need for your website?
*
Approximate number of forms you will need for your website?
*
Are there any existing websites that closely match the functionality and/or design style you wish to have for your new website?
http://
Select your site content:
*
Contact
Illustrations
Graphics
Selling Anything?
Clients/Customers
Products & Services
Portfolio
About Us
Photographs
Upcoming Events
News/Press Releases
* Other: (Describe below):
Logo Upload:
Photo & Art Uploads:
Additional photos can be emailed to info@jandcdesigns.com
Will you need a new designated email address for this site other then your personal email address?
*
Yes
No
If so, how many new email addresses?
List email addresses you would like for your website: (For example: xxxx@webaddress.xxx)
Colors for your website:
Design Notes: (Clean, lots of white space, colorful, gradients, slide shows, etc.) Or designers choice:
* Do you have any additional comments and/or requirements that you feel may be important?