Web Design Assesment Form Customer InformationName* First Last Phone*Phone to be displayed on websiteEmail* Email to be displayed on website Color SchemeList below up to three colors which we will emphasize in the color scheme of the site.Color 1:Color 2:Color 3:PagesPlease provide us with information about the different pages you want for your website. You can create up to 5 pages.Page Title (ex. Home)Page DescriptionText Content Social Media/MusicPlatform (Ex. Facebook, Twitter, Instagram, SoundCloud, Spotify, etc.)URL Image FilesPlease upload any images you might want on your website. Please title the image files with the page name and number of image. Ex. "Upcoming Events 1". Don't forget to include any logos/branding material you may want included! Drop files here or PaymentTotal* Price: $9.99 Note* By checking this box, you agree to the monthly recurring charge of $9.99 for NapCloud's website design and hosting services. *Estimated completion of site development and design is 2-4 weeks after submission. This service does not cater to eCommerce or online sales.Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name CommentsThis field is for validation purposes and should be left unchanged.