New Client Basic Website InfoBasic InfoName(Required) First Last Business Name(Required)(as you want it displayed on website)Your RoleYour title in your business/orgMailing Address(Required)Please enter the address where you receive mail Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Email(Required)Please enter the email address you want me to use to communicate with you. Contact Phone(Required)Please enter the phone number you want me to use to communicate with you.Website BasicsWebsite(Required)If you do not have a website/domain yet, please enter your desired website address Website EmailPlease enter the email address you want used for emails from customers/clients Website PhonePlease enter the phone number you want displayed on the websiteBusiness AddressPlease use the address you would like displayed on the website Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Desired Website Tagline(5-10 word summary of your business, that will be used in the header and on the front page)Website LogoPlease upload the highest resolution available. If you have multiple versions (different colors, different layouts, etc.) please up load all of them. ***.jpg & .png format only - if you have other file types, please email them to me. *** Drop files here or Select filesAccepted file types: png, jpg, , Max. file size: 256 MB, Max. files: 4.Target Date for Website Completion(Required)A rough estimate is OK Month Day YearDomain Name & Current Hosting InformationDomain Name Provider(Required)Who you purchased your website domain (YourWebsite.com) from. For example: GoDaddy, NameCheap, NetworkSolutions, etc.Current Hosting Provider(Required)Who you purchased your website is currently hosted by. (It may be same as your domain provider) For example: BlueHost, HostGator, GoDaddy, etc.Do you know the login information for your domain name provider? Yes NoSome providers allow you to delegate access to me, granting limited permissions so I can manage your accounts without full control. I’ll advise you on how to set this up if applicable.Do you know the login information for your hosting provider? Yes NoSome providers allow you to delegate access to me, granting limited permissions so I can manage your accounts without full control. I’ll advise you on how to set this up if applicable.If you’re unsure how to access this information, I can guide you through the process. However, you’ll need to contact your service providers directly to retrieve or reset login details.If you can't delegate access to me, Please email me the login credentials for your current hosting & domain. If your hosting and domain are managed by the same company, let me know.Additional InfoPlease enter any additional info that you think I might need to know:
