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Business Contact Info
Business Name
Business Address
Business Address
Business Address
Business Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Business Phone Number
Do you currently have a website
Yes
No
Current website address
Do you have a domain name
Yes
No
What is your domain name?
Who is your domain registrar?
Would you like for us to purchase a domain name for you?
Yes
No
Give us some ideas of a domain you would like.
Domain names are subject to availability. We will give you options based upon availability. before it is purchased. Price is subject to extension. starting at $9.00 a year.
Personal Contact Info
First Name
Last Name
Email Address
Phone Number
Tell Us About Your Business
Tell your story. Who are you and what do you do? List products and/or services you offer
We are a leading manufacturer of widgets. We sell to both retail and wholesale customers. Our leading brands are Acme, Toyco and Widget Express. Our business has been built on integrity, customer service and exceptional products with superior service after the sale. Our company was founded in 1920 by John Q. Widget out of the back of his Model T Ford. We carry on with the same values and traditions that has built our company as a staple in our community and now across all 50 states.
Year Business Established
What you do
A brief description of what you do: We build widgets of all sizes, we service widgets in all 50 states, we simply connect businesses who want to buy and sell widgets, we consult other businesses in manufacturing widgets, we entertain people with widgets. It seems simple enough but the clearer you make this descrption the more successful your website will be.
Who you are
A short 1 or 2 sentence description of who you are as a business
What you want to be known for
What you want people in general not simply customers to know about your business
Your Target Market
Who are you trying to reach? The more specific this answer the better we can strategically build your website to that exact target market. Example: 45 year old female with 3 children, or construction companies who use our widgets, or teenagers interested in Star Wars.
What would you like website visitors to do?
Examples include: Call us, fill out a form, watch a video, sign up for discounts with an email address, collect their email address for a mailing list, order a product, ask a question about a product or service, make a donation
Logos, artwork and theme
Does your business have a slogan or tagline?
Yes
No
Would you like us to create a slogan for you?
Yes
No
What is your business slogan?
Do you currently have a business logo?
Yes
No
Would you like a quote for us to design you a logo?
Yes
No
Logo design starts at $125.00
Would you like to upload your logo now?
Yes
No I will do it later
Logo Upload
Drop a file here or click to upload
Choose File
Maximum upload size: 33.55MB
Do you have a color scheme for your business?
Yes
No
We will get more specific details but what color(s) are they?
Do you require custom photography for your website or product images?
Yes
No
Are you ready to upload your photos now?
Yes
No
Photo Upload
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Choose File
Maximum upload size: 33.55MB
We will provide you with a custom login to upload your photos at a later date. However, please note that your website cannot be completed until we have these photos.
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Potiental Client Form
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About Yourself
Full Name
First
Last
Phone
Email
Preferred Method to Contact
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Phone
Email
Date
Date Format: MM slash DD slash YYYY
About Your Website
Which of the following categories can your firm be classified under?
Accounting/Finance
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Please check what type of accounting services you provide
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Please check what type of entertainment services you provide
Vistor Attractions
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Please check what type of business opportunity services you provide
Information on Permits, Licenses, and Fee Schedules
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Information for Certification
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Please check what type of construction services you provide
General Contracting
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Tenant improvements
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Please check what type of consumer goods you provide
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Durable Goods
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Please check what type of government services you provide
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Inspection and Clearance
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Please check what type of installation services you provide
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Please check what type of insurance services you provide
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Life
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Film
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Please check what type of workforce services you provide
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Please check what type of nonprofit is your firm?
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Please check what type of pharmaceutical services do you provide
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On-Site Pharmacy
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Customer Web Portal
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Real-Time Integration
Pre-Admission Referral
Dispensing Options
--
Preferred Drug Formulary
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Pre-Admit Assessment
Recapture Part D Denails
Part D Plan Guidance
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Split Cost of Medication Supply
--
Pharmacist Services
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Please check what type of professional services do you provide
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Accountant
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Please check what type of quality control services do you provide
*
Accountant
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Evaluator
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Please check what type of estate services do you provide
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Residental
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Please check what type of restaurant services do you provide
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Dining In
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Beer
Buffet
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Lunch Specials
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Please check what type of retail services do you provide
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Department Store
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Please check what type of sales services do you provide
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Management
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Please check what type of research services do you provide
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Physics
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Other
Please check what type of skilled labor services do you provide
*
Construction
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Foremen
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Structural Wlders
Multi-Craft Millwrights
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Please check what type of technology services do you provide
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Please check what type of travel services do you provide
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Buses
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Please check what type of travel services do you provide
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Air Shipping
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Other
Please describe your business category.
What do you want to be known for?
Now tell us about your business
What is your target age?
Who is your target demographic?
Please describe what audience you are trying to reach.
What do you want those people to do?
What specific action do you want them to take?
Examples: Send an email, call your business, join an email list, download files, order a product or service
Do you currently have a website or domain name?
Yes
No
Preferred Website URL
*
What would you like your website domain name be?
This will depend on availability
What is your current domain name?
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Images
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Customer Service Manager
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Bryan
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