intake form - Ebda3i

Client & Business

Basic business details to display across the website.

Full name *

This field is required.

Business name (exact spelling) *

This field is required.

Your role

Business email *

Enter a valid email like name@domain.com

Business phone

Business address (if applicable)

Operating hours

City / State / Country

What does your business do? (1-2 sentences) *

This field is required.

Brand & Content

Identity, tone, and media.

Do you have a logo? *

Please choose an option.

Brand colors (if any)

Preferred style

Describe your brand in 3-5 words

Do you have professional photos? *

Please choose an option.

Use stock images if needed? *

Please choose an option.

Social links to display

Pages

Content needed for Home, About, and Contact.

Home page headline *

This field is required.

Call-to-action button text *

This field is required.

List your main services (one per line) *

This field is required.

Key selling points (why choose you?)

Founded year

Mission / values

About story (short)

Preferred contact method

Domain & Hosting

Domain and hosting info (if you already have it).

Do you already own a domain? *

Please choose an option.

Domain name (if yes)

Where is your domain registered?

Do you have hosting already? *

Please choose an option.

Hosting provider (if any)

Do you want help purchasing domain/hosting?

Review & Agreement

Confirm details and submit.

Agreement *

I confirm that all information provided is accurate to the best of my knowledge, and I approve using it to create my website.

This includes business details, services, branding preferences, and contact info.

You must agree before submitting.

Full name as signature *

This field is required.

Date *

This field is required.

Extra notes or requests

Submission sends via EmailJS to mazen200855@gmail.com. Internet is required.