Website Service Intake Form

1 You & Your Business

2 Goals & Pages

3 Design

4 Domain & Hosting

5 Timeline & Submit

6 Review & Sign

Step 1 of 6 - You & Your Business

Let us know who you are and what your business is about.

Contact Information

First Name *

Last Name *

Email Address *

Phone Number *

Preferred Contact Method *

Email Phone Call Text Message

Best Time to Reach You

Your Business

Business / Organization Name *

Tagline or Slogan (if you have one)

City *

State *

Business Phone

Business Email

Business Address (if applicable)

Industry / Type of Business *

Tell us about your business *

How long have you been in business?

Step 3 of 6 - Design Preferences

Help us understand your visual style and what you want your website to feel like.

What design style best fits your brand? *

Brand colors (hex codes, color names, or describe)

Font preferences (optional)

List 2-3 websites you like the look of (any industry)

Any styles you definitely do NOT want?

List your main competitors websites (if applicable)

Step 6 of 6 - Review & Sign

Review the agreement below and add your signature to complete your submission.

Your Signature

Draw your signature and initials in the boxes below. Use a mouse, trackpad, or touchscreen.

Client Signature *

Client Initials *

Type your full legal name * By typing your name and signing above, you agree this constitutes a legally binding electronic signature.

I have read and agree to the terms of the Amnis Beacon Web Design & Development Agreement. I understand that my electronic signature above is legally binding.

✓

You are all set!

Your intake form and agreement have been submitted successfully. We will review everything and be in touch within 24 hours via your preferred contact method.

Check your email for a confirmation with your submission reference number and a copy of your signed agreement.

Next step: we will send you a secure link to share any login credentials privately.

Step 1 of 6 - You & Your Business

Contact Information

Your Business

Step 2 of 6 - Goals, Features & Pages

Website Goals

Pages & Content

Step 3 of 6 - Design Preferences

Step 4 of 6 - Domain, Hosting & Integrations

Domain & Hosting

Integrations & Tools

Step 5 of 6 - Timeline, Budget & Final Details

Timeline & Budget

Access & Credentials

Anything Else?

Step 6 of 6 - Review & Sign

Your Signature

You are all set!