Web Design Form

Please complete all of the fields as it will help us better understand your needs and design a site that meets all of your requirements. This also helps expedite the project. Please skip any field that you feel is not related to your project.
Company Name
CORPORATE HQ
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Website
Do you have any additional email you want to add to the site?
Use this format and enter each email in a new line: sales: sales@domain.com
2ND LOCATION
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
3RD LOCATION
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
PROJECT CONTACT
Name
First Last
Phone
Email
Desired Due Date
Date Format: MM slash DD slash YYYY
Planned Launch Date
Date Format: MM slash DD slash YYYY

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Home	Products	Services	About Us	Contact Us	Shop

Level 1 - Home	Level 1 - Products	Level 1 - Services	Level 1 - About Us	Level 1 - Contact Us	Level 1 - Shop

Level 2 - Parent Item	Level 2 - Parent Item	Level 2 - Parent Item	Level 2 - Parent Item	Level 2 - Parent Item	Level 2 - Parent Item

Social Media Site	URL Link	Login ID	Password

CORPORATE HQ

Video Source - You Tube, Vimeo etc.	URL Link - Please provide the complete link

To Page - Use the page name from the menu section	From Source - Site Name, Document Name	From - URL Link, Document type if source was a document

Header	Body	Footer

Header	Body	Footer

Google Analytics Code	Google Login ID	Google Account Password