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  * Fields are mandatory

Please provide the basic information needed to get your website Started.

More detailed information can be added once your website is live.

  * Client Name & Surname :
  * Current Email Address:
  * Contact Number:
  * Business Name:
  Business Slogan:
  Physical Business address:
  Domain required (
  Domain transfer Required - give Domain name:
  E mail address Required ( ex:
  About Us Text - (tell your story to capture the essence of who you are as a company and as a brand):
  Home Page - What would you like to see on your home page:
  * Contact Information to be Used on Website:
  Company Logo:
  Frequently Asked Question + Answer 1 :
  Frequently Asked Question + Answer 2 :
  Frequently Asked Question + Answer 3 :
  Examples of Websites you like (completely optional) :

Load Pictures to be used on Home Page (not compulsory)

Additional Images can be mail to me -

  Homepage Image 1:
  Home Page Image 2:
  Home Page Image 3:
  * Website Selection:
  R 500 - Basic website
  R1500 - Standard website
  R2500 - Design Standard website
  R3200 - Custom website
  Colour Choices for your Website:
  Add any Additional Request or Comments: