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Client Website Request Form
Please take your time to fill in this form, this will help us develop the exact type of website you wish for.
Please enable JavaScript in your browser to complete this form.
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__________________________________________
Tell us a bit about yourself
Company Name
Contact's Name
*
First
Last
Contact's Position
*
Email
*
Email
Confirm Email
Phone
*
Website / URL (if any)
Address
*
Address Line 1
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
What does your company do?
*
__________________________________________
Let's get down to busines
Do you have a URL in mind for your business
*
Yes
No
Enter your url here
*
Do you need us to buy your domain
*
Yes
No
Whats your deadline for the project
*
Date
Time
Could you give us a ballpark figure for your website project
*
__________________________________________
The next few questions will help us understand exactly what you're after with this site.
Go ahead, tick as many as need to.
Next
I want this site because:
I need to build awareness for my brand
I need to offer a contact point to my clients
I need my company to have a better image online
I need to sell my product/service through my site
I need to use it to build customer loyalty
I need to reach people in many languages
I have my own reasons
Do you mind sharing your own reasons with us
*
Yes
No
Please do share with us your other reasons
*
__________________________________________
My site will be built to target
*
Kids and teens
In their 20s
in their 30s
in their 40s
in their 50s
senior citizens
My clients come to me because
*
I offer excellent services
I have the best product on the market
I have the best prices on the market
__________________________________________
Do you want to expand your target audience in a certain direction ?
*
__________________________________________
More specific features of your customers
Next
Someone is searching the web for your business. What words or phrases will they likely search for in Google ?
*
__________________________________________
What is it that makes your services unique on the market?
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Do you have any proof that your solutions are better than your competitors'?
*
__________________________________________
Our new website would need to include:
Responsive design for use on tablets & mobiles
Online Magazine
Online forum/blog
Newsletter system
Separate dedicated landing pages
Additional requirements
Please not our websites are build using a WordPress Content Management System.
Additional Requirements
*
__________________________________________
Specific features to be included in our new website
Next
We want the following special features to be included in our new website:
*
Registration Form
Registration
Video Streaming
An online store/sopping cart
Search Panel
Online Payment Gateway
Multi-column layout layout Newsletter/Email
Blog Module
Signup forms information / request
Login
Image Slider
Other Features
Other features you want to included in your website
*
What Are Three of Your Favorite Websites (And Why?)
*
Indicate what you like about the websites, e.g color, fonts, UI (User Interface) etc
__________________________________________
Help us out here, who will provide the following resources
Stock photography
*
us
client
Company Photography
us
client
Other Artwork/illustrations
*
us
client
Copy-writing Text
*
us
client
Professional logo
*
us
client
Graphic Design
*
us
you
Other print collateral
*
you
client
Meta tags/ description
*
us
client
__________________________________________
Moving on to the pretty stuff
Next
Moving on to the pretty stuff: Design
Does your company have a logo/ established image & branding guidelines (e.g fonts, colour, colour schemes etc )
*
Yes
No
Do you have print materials (such as business cards or brochures) that we need to match?
*
Yes
No
__________________________________________
What will happen once we deliver the site?
Would like us to update your site, or would you like to be responsible for updates?
*
yes
no
How often do you require updates
*
Weekly
Monthly
Quarterly
We'll also perform full site backups for your website
__________________________________________
Is there anything else you would like to tell us, concerning your website?
*
no
yes
What would you would like to tell us, concerning your website?
*
GDPR Agreement
*
I consent to having this website store my submitted information so they can respond to my inquiry.
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