Web Design Intake Form Can't complete this whole form right now? Click "Save and Continue Later" at the bottom of the form. Web Design Intake Form: About You / Your BusinessYour Name* First Last Your E-mail* Business NameYour TitleAddress or Business Location Street Address City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican 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 RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican 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 RicoQatarRéunionRomaniaRussiaRwandaSaint 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 IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country PhoneGoal / Mission StatementDescribe products and/or servicesDescribe your ideal website visitors and/or customersWhat do you hope your website visitors will do after visiting your site?For example, call to schedule an appointment? Complete your contact form? Purchase a product or service?Top 3 competitors or similar companiesPlease include locations and websites, if known. Save and Continue Later Web Design Intake Form: Current Website // DetailsDo you currently have a website?YesNoCurrent website's URL Keep the current URL for the new website?YesNoWho manages the current website? For what tasks are they responsible?What DO you like about the current website, and why?Please be as detailed as possible.What DON'T you like about the current website, and why?Please be as detailed as possible.Is your current website mobile friendly?YesNoDon't KnowHow many hits does your website get per month?Leave blank if you don't know.Marketing and tracking tools currently in useFor example, e-mail marketing such as MailChimp or ConstantContact, or analytics such as Google Analytics. Save and Continue Later Web Design Intake Form: Current Website // Hosting & FTPCurrent website's hostBluehostFlywheelGoDaddyHostGatorSitegroundDon't KnowHosting Login UsernameHosting Login PasswordFTP Host / URLFTP UsernameFTP Password Save and Continue Later Web Design Intake Form: Current Website // Domain RegistrarDomain RegistrarWhere is your domain name registered?Domains.comGoDaddyGoogle DomainsNamecheapName.comRegister.com Save and Continue Later Web Design Intake Form: Current Website // CMSCurrent website's CMSWhat software runs the current website?WordPress (Self Hosted)WordPress.comSquarespaceShopifyDon't KnowWP-Admin login pageTypically the login page is located at www.YOUR-URL.com/wp-login.php, however, it can vary. Admin Username or E-mail* Must be an Administrator accountAdmin PasswordLogin CredentialsUsername and/or email, and password. Save and Continue Later Web Design Intake Form: New Website // FeaturesDesired URL for new website What features will your new (or re-designed) website require? Contact Form(s) Google Map(s) Social Media Links News or Blog Posts Subscription Signup Portfolio / Projects E-Commerce Testimonials Other features not listed Contact Form(s) DetailsList all fields you'd like included in the contact form(s), as well as the e-mail address to which you'd like the results sent.Google Map(s) DetailsList all addresses or locations you'd like included in the Google Map. Please note if these addresses are already set up on Google Maps, or if you need assistance getting your business on Google Maps.News or Blog Posts DetailsHow do you plan to use the News or Blog Posts feature? What types of information will you publish? What categories are required?E-Commerce DetailsWhat do you plan to sell on your website - goods, services, both?Describe other features needed but not listedSpecial IntegrationsDescribe any required special integrations, such as with another CMS or sales software.SSL CertificateAn SSL Certificate used to be required for e-commerce sites only. However, now it is essential for every site. Without one, Google will list your website as "Not Secure". Some hosts provide them for free, and some hosts charge an annual fee.Already have an SSL Certificate (current website)Don't have an SSL Certificate (need one) Save and Continue Later Web Design Intake Form: New Website // Content & DesignWho will be responsible for writing the content for the new website?If your content is not ready, please start writing it as soon as possible. The most common reason for a delayed website launch is that there was a delay in writing/receiving the content.Do you plan to reuse any content and/or images from your existing website?What design elements have you seen on other websites that you DO want to incorporate into your website?Think especially of your competitors' websites. List URLs of sites if possible.What design elements have you seen on other sites that you DO NOT want to incorporate into your website?Think especially of your competitors' websites. List URLs of sites if possible. Save and Continue Later Web Design Intake Form: New Website // Project Budget & TimelineProject Budget*Projects under $500 may be considered depending on availability.$500-999$1000-2999$3000-4999$5000+Project Timeline*Do you have a timeframe or deadline for completion of your project? (Please note: RUSH projects will be invoiced a higher rate.)Less than 1 month (RUSH)1-3 monthsNo specific timeframe or deadline Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.