Black Crow Designs/BCD Services

7530 Ebenezer Road
Orrstown, PA 17244
717.477.0686
Business Hours: 10am — 5pm EST

Design Request

Personal Information

Please let us know information below, so we may contact you regarding your new site.
Contact Name:
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Company Name:
Email Address:
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Mailing Address:
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City:
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State:
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Zip Code:
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Country:
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Daytime Phone:
   Example: xxx-xxx-xxxx A value is required.

Web Design Information

Please let us know your choice of design plan and your hosting contract term.
  Type of Site:
Select Design Plan
 Available Add-On Features
 Available Hosting Terms
 Check the box of the add-ons you wish to add to your design if available for your plan choice.
  Online Calendar at an additional cost of $150     Photo Gallery at an additional cost of $150
  Personal Blog at an additional cost of $300     Articles/Library Section at an additional cost of $150
  Constant Contact at an additional cost of $75
  Is this a re-design of an existing Website?
 Yes No
  will you need a quote on us entering the information?
 Yes No

Domain Name Information

Give us the details of your website domain.
  Do you already own your domain?
 Yes No
  What is Your Domain Name?
If you do not already own your own domain name, and we are including your domain name with your design request, we will purchase the domain mentioned above. Please be sure to check for availability before submitting your domain request.

Payment Information

Please let us know what type of payment you wish to use.
  Type of Payment:
  Credit Card Number:
Expiration Date:
     
CVV Number:
   What is This?
  If paying with Paypal, Login/Email Address:
We do not actually charge your credit card. When we are finished with your website, you are sent an invoice for the fees. We only ask for a credit card in case you do not proceed in the development of your site and we have already purchased the domain name and/or created your graphics. At that time, we will apply a 20% fee to your credit card on file and the domain name will be put into your email account. It will be your responsiblity to renew that domain name and assign server information.

Comments

If you have any questions or special requests, please let us know?

How did you hear about our services?

It is always helpful to know how you found out about services, please complete the info below.
  Select Source:
If A Friend or Existing Client, please tell us whom?

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©1998-2008 BlackCrowDesigns.com is a division of BCD Services. All rights reserved. No content may be removed or used without permission from BlackCrowDesigns.com.
All rates and fees listed here are subject to change without notice. All logos, graphics, banners and page sets will be created just for you, but may use parts and images from other graphics we have done. We make no guarantees of sales or success of your website, that will depend on your market and your products. By using any of our services you are agreeing to our Terms of Use and User Agreement.
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