Website Design Form Step 1 of 13 7% Welcome! Please use the following form to input information about your business or organization. The purpose of this form is to ensure that your new website contains all the necessary information for your audience. Only the fields with a red asterisk are required.Company/Organization InfoCompany/Organization Name(Required) Tagline or Slogan Do you have a logo?(Required) Yes No File(Required)Max. file size: 300 MB.Are you interested in design services to create a logo for your business?(Required) Yes No, please use regular text for my company name Design services are available for an additional charge. If no, we will input your business name as regular text in a professional font.What is the domain name/URL that you want for your site?(Required) Do you own this domain already?(Required) Yes No Unsure Do you have access to the account where the domain name was purchased?(Required) Yes No Where is the Domain registered?(Required) Business Contact InfoBusiness Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country This will be listed on your website. Leave blank if you do not want a physical address on your site.PhoneMain company phone number. This will be listed on your website. Leave blank if you do not want a phone number listed on the site.Email(Required) Company email address which will be listed on the site and will receive Contact Form submissions Business HoursDoes your business have specific hours? Yes No List your business hours here:(Required) Details About Your Business or OrganizationAbout Us - Longer Description(Required)1-3 short paragraphs explaining what your organization is about. This will be the main text on the About Us page.Short Company Description(Required)2-5 sentences explaining what your organization is about. This will likely be included on the homepage Your Services or FeaturesPlease list at least 3 services, features, offerings or descriptive adjectives about your business or organization. Examples: Generic Business: Fast & Reliable, Experienced, Caring Support Medical: Adults & Pediatric Care, Same Day Appointments, Award Winning Staff Doctor: Physicals, X-Rays, Vaccines, General Care Business: Legal Services, Contracts, Mergers & Acquisitions Author: Best-Selling Writer, Creative Storyline, Available for Public Events Spa: Relaxing Environment, Variety of Treatments, Professional Staff Restaurant: Fine Cuisine, Friendly Staff, Free DeliveryService #1(Required) Info about Service #1(Required)Service #2(Required) Info about Service #2(Required)Service #3(Required) Info about Service #3(Required)Additional Services Website PagesA standard website will include the following pages: Homepage, About Us, Contact. Please list any additional pages that your site needs in the box below. Some examples include, Donation Form, Photo Gallery, Testimonials, Appointment Booking, Blog, Menus, Shopping Cart etc.Checkboxes Donate Photo Gallery Video Gallery Testimonials Appointment Booking Event Calendar Blog Shopping Page/Cart (Ecommerce) Restaurant Menu Media and News Other PagesPlease list any other pages that you'd like here. Call to Action (CTA)What is the main action you want visitors to do when visiting your site? *(Required) Examples: Free Consultation, Schedule a meeting, Purchase a product, Download a file etc.What page do you want to drive visitors to the most? Is there a specific page within your site that you want to drive traffic? Examples include a Contact Page, Shopping Page, Event Registration etc. ColorsDo you have specific colors or branding? Yes No List your colors or branding requirements here:(Required)You can list specific colors or HTML colors such as #fa134a. PhotosDo you have any photos to include on the site?YesNoPlease email your photos to info@ajedigital.com. Include your business name in the Subject Line of the email. If you have too many photos to send in one email, contact us at info@ajedigital.com and we will send you a Google Drive link where you can bulk upload all photos. Social Media LinksDo you have Social Media pages?(Required) Yes No Facebook Instagram Twitter Pinterest Other #1 Other #2 TeamDo you want information about your team/staff/administration listed on the site?(Required) Yes No Please email team photos and short bios to info@ajedigital.com. Include your business name in the Subject Line of the email. If you have too many photos to send in one email, contact us at info@ajedigital.com and we will send you a Google Drive link where you can bulk upload all photos. Your Personal Contact InfoName(Required) First Last Email(Required) Phone(Required) Website Design Form Which payment option do you prefer?(Required) Regular upfront cost as per the proposal + ($30/month hosting) $1 down + Ongoing Monthly Subscription Fee Additional Info - LAST CALL!Please use this area to include any additional information which you have not already added.
