| Fax form to: 605-278-6348 |
Mail form to: Michelle Mollman Dakota e Ranch HC 63 Box 44 Ludlow, SD 57755 |
Phone: 605-278-6303 Email: webmaster@dakotaeranch.com |
|
Choose Your Domain (website) name |
|
| *Choice #1: | www.dakotaeranch.com/_________________________ |
| Choice #2: | www.dakotaeranch.com/_________________________ |
|
Your Contact Information Your contact information will be used for the return address labels you receive for ordering from our supply store. *Required |
|
| *Name: | __________________________________ |
| Company Name: | _______________________________________ |
| *Street: | _______________________________________ |
| *City: | _______________________________ |
| *State: | _______________ Zip code: ___________________ |
| We are currently taking only United States customers | |
| *Phone: | ____________________ Fax: ___________________ |
| Email Address: | _________________________________ |
| *Date of Birth: | ____________________(mm/dd/yyyy) used if your password or usernames are forgotten |
|
Basic Information to get your website started |
|
| Topic or Subject of your website | _________________________________ |
| How many pages do you think you'll need? | ___________ (If you think you'll need more than 5 pages, there is a $4.00 fee to create each additional pages) |
| List the names of the pages you think you'll be needing (this just helps to get started, you can change this as the website is developed) | _________________________________ |
| _________________________________ | |
| Will you like a custom made "theme" for your website or one of the 60+ standard choices (background, banners, bars and so on) | ____Custom ___Standard |
| List 3 of your favorite colors (helps with designing the theme) | _________________________________ |
| _________________________________ | |