CUSTOMIZED WEBSITE ORDER FORM
City and State
How would you prefer to be contacted?
If you currently have a website, please supply the website address here
Will you need a domain name registered for your website?
List at least 3 domain names you would like to register by 1st, 2nd and 3rd choice preference::
Will you need your website hosted?
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?
Select your site content:
Products & Services
* Other: (Describe below):
Photo & Art Uploads:
Additional photos can be emailed to email@example.com
Will you need a new designated email address for this site other then your personal email address?
If so, how many new email addresses?
List email addresses you would like for your website: (For example: firstname.lastname@example.org)
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?