Skip to content
Home
About DWLI
Blog
Contact Us
DWLI Advantage
Facebook Feed
FAQ
Referral Program
Services
DWLI Social Media Connect Managed Hosting
Email Marketing
Group Email
Pricing
Hosting
Windows Pricing
Linux Pricing
WordPress Pricing
WordPress for non-profits
WordPress Managed Hosting
WordPress Ecommerce
Web Design
Custom Web Design
Custom Landing Pages
Do It Yourself
Other Services
Domains For Sale
Domain Registration
Social Media Management
Web Hosting Features
Hosting Plans
Windows Hosting
Linux Hosting
WordPress Hosting
Cloud
E-commerce
Domain Management
Domain Registration
Transfer your Domain
Domains For Sale
SEO
WordPress
About WordPress
Why WordPress?
Design Services
Custom Landing Pages
Portfolio
Customer Form For Design
DIY Templates
Hosting
WP Managed Hosting
Sign up for WP Maintenance
WP Ecommerce
WP Hosting
WP Host Pricing
WP Non-Profit Hosting
WP For Blogs
Support
Customer Portal
Knowledge Base
WP Self-Help Videos
Support
Payments
Menu
Home
About DWLI
Blog
Contact Us
DWLI Advantage
Facebook Feed
FAQ
Referral Program
Services
DWLI Social Media Connect Managed Hosting
Email Marketing
Group Email
Pricing
Hosting
Windows Pricing
Linux Pricing
WordPress Pricing
WordPress for non-profits
WordPress Managed Hosting
WordPress Ecommerce
Web Design
Custom Web Design
Custom Landing Pages
Do It Yourself
Other Services
Domains For Sale
Domain Registration
Social Media Management
Web Hosting Features
Hosting Plans
Windows Hosting
Linux Hosting
WordPress Hosting
Cloud
E-commerce
Domain Management
Domain Registration
Transfer your Domain
Domains For Sale
SEO
WordPress
About WordPress
Why WordPress?
Design Services
Custom Landing Pages
Portfolio
Customer Form For Design
DIY Templates
Hosting
WP Managed Hosting
Sign up for WP Maintenance
WP Ecommerce
WP Hosting
WP Host Pricing
WP Non-Profit Hosting
WP For Blogs
Support
Customer Portal
Knowledge Base
WP Self-Help Videos
Support
Payments
Website Design Customer Form
Client Custom Design Form
Please fill out the form below and we will contact you about your new website!
Transfer Your Domain Now!
Business / Organization Name
*
Contact Person
*
Phone
*
Email
*
Fax
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Website (if applicable)
Background Information
What is the purpose of your organization?
Who is your target audience? Describe their demographics
Design
This section addresses the overall look of your new site.
Do you already have a logo or company identity (i.e. letterhead, business cards, signage, etc)?
Y
N
Will you need to have a domain name registered for you?
Y
N
Will you need to have a web host set up for you?
Y
N
Would you like new email addresses for your organization?
Y
N
Other Comments
If you already have a site, what do you not like about it (i.e. look, usability, feel, etc.)?
What colors would you like to see in your site?
What overall “feel” would you like to have for your site? i.e., soft, bold, fun
If you have a site where is it hosted?
List 3 sites that you find appealing and describe why. They may or may not be similar to your organization:
1.
2.
3.
Pages
This section describes the pages you’d like to have in your site. Remember that most or all of these pages will appear in your navigation bar and this is how your users will maneuver around your web site. It is assumed that you will have a homepage.
Do you currently have a site?
Y
N
If Yes, will the new site have the same pages (with different layout)?
(note: existing sites can change their pages to fit their needs)
Y
N
About Us/History
Describes your organization
Y
N
Affiliates
A page of links to similar organizations and affiliates
Y
N
Contact Us
This information can appear in two different ways; as part of your heading on every page or a separate page. As a heading, only basic information can be included like address, phone and email. More information, like a map, multiple locations, directions and hours of operation in addition to the basic data requires a separate page.
Y
N
Current Events
Happenings with your organization and/or affiliates
Y
N
Donations
How to make contributions to your organization, where the money is used, etc
Y
N
Information
i.e., an Arthritis organization will have information describing the different kinds of arthritis and how it may be treated. A tennis club will have a page on the rules of tennis, how it is scored, etc
Y
N
Membership
Why join your organization, how to do so
Y
N
Mission Statement
Y
N
Products
Images and descriptions of products you carry without the ability to do online ordering. This is a more comfortable route for those who are getting a new website for the first time and want to ease into e-commerce
Y
N
Profiles
Profiles on organization leaders, volunteer of the year, etc
Y
N
Sponsors
Information on current sponsors, how to become a sponsor
Y
N
Testimonials
What your client has to say about you carries a lot of weight
Y
N
Social Media
Facebook
Youtube
Twitter
Pintrest
Instagram
Other Pages
Each business/organization has unique requirements and special information they want to share with the web community. Please list additional pages that you would like to see on the new website:
Comments
Functionality
This section lists additional functionality you may want to have in your site.
Animation
Y
N
Calendar
Updateable
Y
N
Interactive Form
Usually used for visitors who are requesting specific information from you; i.e. sending a pamphlet or a catalog. They fill out a form and submit it; the data from the form goes to your email box
Y
N
Password protection
Y
N
Rotating images
Usually used for advertising, a different image appears every several seconds
Y
N
Site Search function
Basic search function that allows the user to search the site for a key word
Y
N
Shopping Cart
for e-commerce sites only
Y
N
If Yes, what Payment Processor?
Stripe
Square
Paypal
Other, please specify below
If Other selected above please specify which payment processor you'd like to use.
Other Functionality:
General Notes
18+3
*
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.