*required
Please provide us with some basic information about
your business and website. If you want to
accept credit cards on your site or have other special needs, click here to
request a quote.
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Name of
Business* |
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Address* |
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City* |
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State* |
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Zip Code* |
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Phone* |
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Fax |
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Name of Contact Person*
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Email Address*
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Your email is safe with us. We
don't rent, sell or share customer
information. |
Your Website Design |
You
may choose your own web design
or have us select your web
design for you. Once
selected, web designs
cannot be exchanged. |
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Would you
like us to select your design for you?* |
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If No, please enter the web
design you would like in the box
below. |
Select your website design: |
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Click here to pop up
designs in a new window.
You may need to disable your pop
up blocker. |
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Your Business |
Please tell us
about your
business.
The more
information you
provide, the
better your
website will be.
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What type of
business are you
in?* (ex:
sell fences, dui
attorney, dog
sitter)
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How long have
you been in
business?
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Please list up
to 6 of your top
products,
services or
specialties?*
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What are at
least 3 things
you really want
potential
customers to
know about your
business?*
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Anything else
you want people
to know (ex:
prices, hours,
delivery
information,
etc.)?
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Domain Name |
Click here to find a
domain name (will open new window.)
Enter it here.
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Already own
the domain name you want to use?
Enter it here. |
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Email |
Most
of
our
clients choose
to
forward
email
that
comes
into
their
website
to
an
email
address
that
they
already
have
so
they
don't
have
to
remember
to
check
a
separate
email
account.
Would
you
like
to
forward
your
website
email
to
an
email
address
you
already
have
(ex:
you@aol.com,
yourbusiness@yahoo.com.)?
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If yes, enter your current email address here. If
no, enter No.* |
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Desired Password |
What
Password would you like? It must be
between 5 and 8 characters. |
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By checking this box, I acknowledge that
I have read and accept the
Terms of Service.
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