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Primary Goal - Other
List any social media pages for your business that you would like included on the website.
Other Social Media Links
Send a copy of this order to
What is the AGID for this Website?
Primary Contact Email for Communications
Secondary Contact Email for Communications
Primary Phone Number for Communications
Business Phone - Location
Is your business phone number International or North American?
Email to be Displayed on the Website
Additional Contact Info for Display on your Website
Do you have a physical address that you would like to use?
Hours of Operation
Email for Contact Form Submissions
Contact Form Fields
Contact Form Fields - Other
Please provide us with your domain name and credentials so that we can set your site live.*
I have a domain
I will provide a Domain Registar, Username and Password at a later date
I do not have a domain
Current Website Domain
Website Analytic Tracking Codes
Preferred Web Designs and Competitors Websites
If you don't have images, please select some demographics and we will select images for you.
Related to my business
Choose for me
Please list additional demographics here.
Upload Your Assets
We don't want to deliver an empty site! Your site build includes (500, 1000, 2000) words of repurposed content written using information about your industry found online, including from your existing site. Please let us know if you would like us to write this content for you; if you are providing your own content; or if you would like us to just copy/paste the information on your existing site.
Yes, please write copy for me.
I will provide new copy for you to use.
Just use the copy on my existing website.
Will your site have E-Commerce capabilities?
Additional Functionality / Embed Codes
Likes & Dislikes