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You may contact us by phone at 704.756.3346, 704.231.6451 or
fill our this form as completely as you can and
we will have one of our Account Managers contact you.

Website Information

Your Name:
Business:   
Address:
City:
State:
Zip code:
Business Phone: Other Phone:
Fax:     Email:
Existing website:
Please enter web address if applicable, i.e., www.yourwebsite.com
Why do you want a website?
(Advertise your product or services, create new customers, increase sales, sell products, etc.)
Do you have a theme in mind for your website?
(Professional, corporate, fun, flashy, etc.)
Do you have brochures, logo, photos, text, etc.that we could use in designing your site?
(Please list)
Website Maintenance:
Will your website require maintenance?
Occassionally Monthly Semi-annually Annual Unknown
Will you be using us to host your website? Yes No
Are you a ShoppeCharlotte.com Signature Member?
(Signature Members receive a 10% discount) Yes No
How did you hear about us?
       




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Carolina Website Designs | ShoppeCharlotte.com
PO BOX 480751, Charlotte, North Carolina, 28269
704-756-3346 • 704-231-6451
Carolina Website Designs, in conjunction with ShoppeCharlotte.com is a Charlotte, North Carolina web design company
providing website design and web development services, including eCommerce solutions.