The Social Factory
Primary Contact Information
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Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
*
Format: 0000-00000.
E-mail
*
example@example.com
Business Name:
Please write your mission statement or company slogan, if you have one:
Does your company have a logo? If so, please attach below:
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How long have you been in business?
How many employees does your business have?
Do you or your company have any licenses, memberships or affiliations that you'd like to highlight on your website?
Have you already registered a domain name? If so, what is it and what company did you use to register?
Who is your target audience/customer? (Age, gender, interests)
Website Interview/Expectations
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What is your timeline for completion of the website?
Please Select
ASAP
Within a month
1-2 months
3-4 months
No hurries, No worries
What services are you interested in?
DOMAIN REGISTRATION
WEBSITE DESIGN & DEVELOPMENT
E-COMMERCE/SHOPPING CART
BROCHURE DESIGN
BUSINESS CARDS/LETTER HEAD DESIGN
INTERNET MARKETING & PROMOTION
GRAMMAR & TEXT EDITING
WEBSITE MAINTENANCE
OTHER (PLEASE DESCRIBE BELOW)
What would you like your domain name to be? If you already have a domain, please state it here.
If you currently have a website, why are you designing/upgrading? What would you like to see/change/improve?
What is the purpose of your website? Check all that apply:
E-COMMERCE/ONLINE SALES
IMPROVE CUSTOMER SERVICE
PROVIDE INFORMATION ON PRODUCTS & SERVICES
BROADEN YOUR CUSTOMER BASE
KEEP IN CONTACT WITH CURRENT CUSTOMERS
IMPROVE SITE DESIGN & LAYOUT
IMPROVE FUNCTIONALITY & NAVIGATION
OTHER (PLEASE DESCRIBE)
What are your color preferences? Please mention 3 colors of your choice:
Do you have any reference or competitors website that you would like to submit for review for the design process? Please list the website URL's & specific aspects of the site's that you like:
Please provide a quick layout for your website (sitemap). This should include all pages and subpages for your website. Example: Services > Weddings, Graduations, Portraits
When people visit your website, what would you want them to do? Please check all that apply.
HIRE YOU TO PERFORM SOME SERVICE
JOIN YOUR COMPANY
COMMUNICATE WITH YOU
INFORM YOU ABOUT SOMETHING
SEEK INFORMATION ABOUT YOUR PRODUCTS, SERVICES OR ORGANIZATION
TO BE ENTERTAINED
COMPARISON SHOP OR TO BUY A PRODUCT
CONNECT WITH OTHERS OF SIMILAR INTERESTS
REGISTER FOR AN ACCOUNT, IF YES, PLEASE DESCRIBE.
VIEW BROCHURE
VIEW A CATALOG
ORDER A PRODUCT OR SERVICE ONLINE
SEEK SOME INFORMATION
Would you like an intro page before the homepage (landing page)? With or without flash?
Do you have any preferences as far as images for your homepage?
Do you have any additional text/content for the homepage?
Upload image(s) below:
Upload a File
Drag and drop files here
Choose a file
Cancel
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Please submit any other information pertaining to your site below.
Advanced Website Options
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Please select any of the following additional features you would like:
ABOUT US
CONTACT INFO
PERSONNEL BIOS
TESTIMONIALS
FAQ'S
SERVICE/PRODUCT DESCRIPTIONS
EVENT CALENDAR
CLASSIFIEDS
GUESTBOOK
CHAT ROOM
OPINION POLL
SHOPPING CART
LINKS
PHOTO GALLERY
CONTENT MANAGEMENT
MAILING LIST (ANNOUNCEMENT ONLY) THIS IS WHAT YOU USE TO SEND OUT ANNOUNCEMENT OR EMAIL NEWS LETTERS.
MAILING LIST DISCUSSION GROUP
ONLINE MESSAGE BOARD ON FORUM
CONTACT, SUBSCRIPTION, SURVEY OR FEEDBACK FORMS
PASSWORD PROTECTION FOR CERTAIN PAGES
SITE SEARCH ENGINE
MUSIC CLIPS LISTEN/DOWNLOAD/UPLOAD
VIDEO CLIPS VIEW/DOWNLOAD/UPLOAD
FILE UPLOAD (TYPE OF FILE)
NEWS FEED
How will you be accepting payment through your website? Please check all that apply.
TRADITIONAL PROCESSING (CHECKS, MONEY ORDER, ETC)
MANUAL CREDIT CARD PROCESSING (PROCESSED BY THE MERCHANT)
REAL-TIME CREDIT CARD PROCESSING (AUTOMATICALLY PROCESSED ON CHECKOUT)
N/A
Are there any additional features you wish to add which have not been mentioned above? Please mention here:
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