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Web Design Registration Form
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Client’s Name
*
First
Last
Client’s Phone
*
Client’s Email
*
Business Type/industry
*
Website Purpose
*
Business
Portfolio
eCommerce
Blog
Other
Current Website (if any) (URL Input)
*
Preferred Domain Name (Text Field)
*
Number of Pages
*
Single page – 500 USD
Single page – 500 USD
2-5 Pages – $900 USD
6-10 Pages – $1,500 USD
11+ Pages – Custom Quote
Checkboxes
*
Yes
No
Color Preferences
*
Typography Preferences
*
Websites Description Color
Reference Websites (if any)
*
Project Description
*
Brand Guidelines (if applicable)
Specific Features Needed
*
Contact Form
Contact Form
Blog Section
eCommerce (Shop)
Booking System
Portfolio/Gallery
Social Media Integration
SEO Optimization
Content Writing Needed?
Yes
No
Hosting & Maintenance Package?
Yes
No
Custom Email Setup?
Yes
No
Budget
Selected Value:
500
Deadline
*
Work Order Submitted By:
*
First
Last
Submitter’s Email
*
Email
Confirm Email
Submit
