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Efarley Web Media & Graphics®

Application for Website and Media Services

CLIENT / CUSTOMER INFORMATION

 The information collected in this section is for EFP account purposes only.This information will not be displayed on websites or media

Application Date:

January 25, 2024 at 9:11:19 PM

Client Name:

Client Number:

Patrick

Jackson

20120717

Business Name:

New Culture Striving

Client Email:

Client Phone:

510-395-1481

How did you hear about EFP®?

Friends/ Family

Communication Preference 

Text

WEBSITE DETAILS

 Use this section to tell us about your desired website. Once we have received your application, you will be provided options on how to submit your content.to the designer, such as product images, price list, mission statements, etc.

Domain Name:

Do you own this domain?

NO

Website Vision

Customer should be able to view services
Make Contact
Click on Social Media Accounts
u-haul
Controlled Reviews

Business Colors

No set Color

Business phone:

510-395-1481

Business email:

Logo File

Logo PNG - CC Resume Solutions 2.png

AVAILABLE PACKAGES

Use this section to select the service option that works best for you. For more details on available options, visit our services page at www.efarley.com

Design Level

Template Website - $199 Startup fee

Email

No - I will use my exsisting email

Package

Starter Package - $99.99 monthly fee

Paid Ads

No - I do not need Social Media Ad Support

BILLING DETAILS

Use this section to update your billing preferences. If you select the invoice option, do not enter your card information.  We will send your invoice to the email address you provided in section 1

If box check, send Client invoice

Name on Card

Card Number

Card Expiration:

/

CCV:

Address:

If box check, turn ON AutoPay

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