Website Development Form

Insert your website information below. If you do not have all information, gather it first, then come back and submit it. This form does not allow you to save your information and come back later. All fields with * are required.

If you have questions please email us at support@webnology.biz.

* Full Name

* Email

* Enter Website Design NumberWhat is the Website Design number you paid for?

1.0 Website Components

* Do you already have a Domain Name or Website?

Enter your Domain Name or Websiteex. - www.business.com

* Do you need a Business Email Address?ex. - john@webnology.com. A business email address is important. You do not want a Google or Hotmail email address. When doing business you want your email address to match your business name.

YES

NO

2.0 Website Information

Page 1 - Home pageOur web designers will place the highlights of your business on the home page. If there is some information you want to make sure is on the home page, enter it below.

Home page File & Image UploadIf you have images or files you want to display on the home page, upload them here. Otherwise, our designers will place stock images on this page.

Page 2

Page 2 TitlePage 2 is usually the About Us page, however, you may name it anything you'd like.

Page 2 Description The About Us page is standard and tells the customer about who you are, why you are in business and the purpose you exist. Place the information regarding this page below.

Page 2 Files and ImagesIf you have images or files you want to display on this page, upload them here. Otherwise, our designers will place stock images on this page.

Page 3

Page 3 TitleEnter page 3 Title below.

Page 3 DescriptionThis page can be use to tell the customer about your product or service. Place the information regarding this page below.

Page 3 Files and ImagesIf you have images or files you want to display on this page, upload them here. Otherwise, our designers will place stock images on this page.

Page 4

Page 4 TitleEnter page 3 Title below.

Page 4 DescriptionThis page can be use to tell the customer about your product or service. Place the information regarding this page below.

Page 4 Files and ImagesIf you have images or files you want to display on this page, upload them here. Otherwise, our designers will place stock images on this page.

Page 5

Page 5 TitleThe last page is usually the Contact Us page. However, you may name it anything you would like.

Page 5 DescriptionIf you are using this page as the Contact Us page, list information where the customer can contact you. Example, address, phone and email address.

Page 5 Files and ImagesIf you have images or files you want to display on this page, upload them here. Otherwise, our designers will place stock images on this page.

3.0 Payment Setup

The below payment method will be used for your monthly website service, domain and email renewals, etc. if purchased from Webnology. No payment will be processed now without your approval.

* Name on Credit Card

*Credit Card Numberex. 4111-2222-3333-4444

*Expiration Dateex. 01/25

* 3 Digit CodeEnter the 3-digit code on back of credit card.

SUCCESS!