New Website Order Form

CONTACT INFORMATION:

*YOUR NAME:

*PHONE NUMBER:

*EMAIL ADDRESS:

ORDER INFORMATION:

*BUSINESS NAME: (as listed on website)

*WEBSITE TYPE:

BUSINESS WEB ADDRESS (if they have one):

OPTIONS:

*DO WE NEED TO REGISTER DOMAIN NAME? (reg. is $1.50⁄mo. per domain)

LIST WEB ADDRESS CHOICE(S) (if they don't have one):

*HOW MANY SITES? (Setup cost not to go below $225)

*DO YOU WANT THE COUPON CLUB SETUP?
(if yes, please provide unique email and user ID for client account)

If you want email the collection form (coupon club) added to your home page you must provide an email address and user ID to assign to the database. Please type these in below. If you do not include them the site will be created without a coupon club.

PARENT PAGE (based on parent page template)

MENU CONTENT:

NOTES FOR MENU CONTENT:
Please provide notes as to menu content.

SPECIAL INSTRUCTIONS:
Please describe in detail any special instructions on the design.

BUSINESS ADDRESS(s) AND PHONE NUMBERS:
Please type in address and phone to be displayed on site.
If you do not include this info you can put in in yourself at a later time.

BUSINESS HOURS (if to be displayed on site):
If you do not include this info you can put in in yourself at a later time.

ATTACH LOGO AND GRAPHICS:
(You may submit multiple graphics, but you must attach each one separately... you can also zip your files and attach as one attachment)

Please attach logo, photos or graphics you would like included on your site.

NOTE: please be sure that attachments are not larger than 4 megabytes in size and total should not exceed 15MB. If they are, you can shrink the file size or send them by email to: [email protected].

PLEASE DO NOT CLOSE THIS BROWSER WINDOW UNTIL UPLOAD IS COMPLETE

*AGREEMENT CONFIRMATION: (required)   By selecting YES and submitting this form, you agree to all pricing for this site build and any added options (selected above).