Contact Person for the Website Design Process*

First Last

Contact Person Phone*

This is the phone number where we can reach the person who is in charge of making decisions for the website design process

Will the website be for*

Website URL*

Do you have an Existing site on this domain name?*

Yes
No

Website Login URL

Where do we login to access the Admin or Dashboard of your existing website

Username

The username you use to login

Password

The password you use to login

Name(s) to go on website*

This field is for the contact name or names to be placed on the website. Typically these will be displayed in the website header, footer and contact page.

Company Name*

Primary Email Address*

This is the email address where all contact forms will go and IDXBroker Leads & will also be displayed on the website header, footer and contact page.

Primary Phone*

This is the primary contact phone number to go on the website & will also be displayed on the website header, footer and contact page.

Choose your Theme

Domain Name Info

This is where you bought your domain name & how we will be administering to it. It is needed so we can set up your CNAME for your IDXBroker account and also to set your NameServers to point to our hosting. If you want us to make the changes to your domain name when it is time to go live then we will need access to your Domain where you purchased it.

Where did you Buy your Domain Name?*

Godaddy (http://godaddy.com)
Network Solutions (http://networksolutions.com)
Enom (http://enom.com)
namecheap (https://www.namecheap.com)
YourSiteNeedsMe.net (http://yoursiteneedsme.net)

Username

Hint* For Godaddy this is your Customer Number

Password

4 Digit Call in Pin

Do you have an email address associated with this domain? Ex. you@yourdomainname.com*

Yes
No

Where did you purchase/setup your email?

IF different from your domain registrar please also provide the login so we can access it to determine your MX records before we make your new site live and avoid interruption to your emails.

Social Media Sites

We can connect your site to your social media so that when you post a blog to your website it will auto syndicate to your Social Media sites like Facebook & Twitter.

Facebook Page URL

Do you want to Connect your Blog/website to Facebook?*

Yes
No

Facebook Username - This is your email address

Facebook Password

Please double check this is the correct password before submitting this form

Twitter Page URL

Do you want to Connect your Blog/website to Twitter?*

Yes
No

Twitter Username OR Email

Twitter Password

Do you want to Connect your Blog/website to Google Analytics & Google+?*

Yes
No

Google+ Page URL

Gmail email address

Gmail Password

YouTube Page URL

Linkedin Profile URL

Pinterest Page URL

Instagram Profile URL

About You

Mobile Phone

We need this so we can set up Text Lead Alerts

Do you want your Mobile Phone to appear on the website?

YES
NO

Office Phone

Do you want your Office Phone to appear on the website?

YES
NO

License #

ONLY fill this out if you want it to appear on your website and/or if it is needed for MLS compliance

Company License #

ONLY fill this out if you want it to appear on your website and/or if it is needed for MLS compliance

Office Address

Street Address Address Line 2 City State ZIP Code

ONLY fill this out if you want it to appear on your website

Email Signature

Please copy your Email Signature here

What is your MAIN city you work in

Name your next top 4 cities

Please upload your photo in HIGH resolution

Please upload your LOGO in HIGH resolution

Please upload your Bio in Document Form

Please do not upload a PDF. ***IMPORTANT: Skipping this field will forfeit your About Us page in this special deal!!

Please upload your Testimonials

Please upload a Word or Pages Document containing your Testimonials. **Please do not send us links to Zillow or other online sources. We do not accept links for Testimonials. ***IMPORTANT: Skipping this field will forfeit your Testimonials page in this special deal!!

Color Scheme & Additional Info

Color Scheme

Please tell us about the color scheme you want to use on the site. If you have specific Colors you want to use you can include Hex codes. Or you can include other sites you have seen that you like.

Additional info or comments

Please tell us any additional information you want us to know

Terms & Disclaimer

By checking the boxes below you are the person purchasing this site or a representative thereof & confirm that you have read and agree to the Terms & Disclaimer set forth by YourSiteNeedsMe, LLC and Charra Hammett. Please click this link to view the details of this agreement: https://yoursiteneedsme.com/disclaimer/

Terms & Disclaimer*

I have read and agree to the Terms & Disclaimer

Backup

I agree to make a backup of my existing site within 24 hours

Additional Fees

By checking the boxes below you are the person purchasing this site or a representative thereof & understand that any special additions outside of the regular setup & theme design will be charged at $85/hour or $125/hour for non IDXBroker Developer Partners & must be paid in full before project goes live. Setup includes Theme Options (colors, settings, formatting, theme license for 1 year) Home Page Design, Header, Footer, Sidebar, Google Analytics installation & setup, Additional Premium Plugin setup as needed/required. Current website page content copied over at YourSiteNeedsMe & Charra Hammett's discretion.

Additional Fees*

I have read and agree to the Additional Fees

After you submit this form you will be taken to the IDXBroker Signup page. If you have already signed up for IDXBroker you can skip that page.