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Media Worx

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  • Website Development Client Information

Website Development Client Information

Please fill out the form below with as much information as possible to help with the set up of your website.

Website Development Client Information

MM slash DD slash YYYY
Name(Required)
Billing Address(Required)
Do you already own a Domain Name for your site?(Required)
This is will be the Primary Admin Email Address tied to your accounts. If you don’t have your domain name yet, write the desired email addresses in the format john@mydomain.com
If you don’t have your domain name yet, write the desired email addresses in the format john@mydomain.com
If you don’t have your domain name yet, write the desired email addresses in the format john@mydomain.com
If you don’t have your domain name yet, write the desired email addresses in the format john@mydomain.com
Should be a minimum of 8 characters and contain at least one number, one Capital letter, and optionally, one special character.
Social Media Acccounts
Check each social media account you want your website to link to.
Separate multiple entries with a comma
Will you sell products on your site? (e-Commerce Set Up)
What Types Of Products Will You Sell
Select all that apply
What Shipping Services Will You Use?
Check all that apply
Shipping Zones
Where will you ship to? Select all that apply.
List your primary product categories. (i.e. Shirts, Pants, Shoes, Men’s, Women’s etc) Separated answers with a comma.
Email Marketing
Will you want to integrate an email marketing service such as MailChimp, MailPoet, or AWeber?

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