DubLi Website Order Form

Please fill in all the fields in the form below to order your DubLi website

 

Personal Details

These details are for our office use only and WILL NOT appear on your website...

Name:
Phone Number:
Mobile Phone:
Email Address:
DubLi Associate Number:
   
Who referred you to us?
If not referred, how did you find us?

 

 

 

 

Website Details


These are the details you would like to appear on your website. 

If you prefer any of these details left out completely, please enter "N/A" into the appropriate field.

 

Name:
Phone:
Email:

 

 

 

 

Configuration Details

 

These are the details we need to configure your website and get it up and running.

 

Template Number Please enter your chosen template number

Can't Remember?  CLICK HERE to have another look at our templates.

 

 

   
 

Domain Name

 

You will need to supply us with a domain name (eg: www.domainname.com).  If you don't have a domain name, you can purchase one through...  www.GoDaddy.com or www.CrazyDomains.com.au

 

 

   
 

Domain Name Registry

 

We need to know where you bought your Domain Name from - this is called your Domain Name Registry.
eg;  www.GoDaddy.com or www.CrazyDomains.com.au

 

 

 

 

 

In order to re-assign the Domain Name Servers to host your website, we will need access to your account.  Please provide the following...


User Name:
 

 

 

Password:

 

 

   
Links: We need to know exactly where you would like your visitors directed to, when they click on the 'Free Account' or the 'Business Opportunity' buttons.  Please supply us with the URL for each button.

 

"Free Account" Link

 

 

"Business Opportunity" Link
(if you would like your visitors directed to the contact form, please write 'Contact Form' in this field.)

   
 

Contact Form Email:

 

When a visitor submits their details via the 'Contact Form' on your new site we need to know which email address you would like these details sent to.

 

 

   
 

New Email Address:

 

Included in your order is a personalised email address.  This can be 'YourName@YourDomainName.com' or 'info@YourDomainName.com' or what ever you like.


   
 

Email Re-Direction:

 

This new email address (above) will need to be re-directed to an existing email.  Which existing email address would you like it re-directed to?


   
 

Photo:

 

Would you like to include a personal photo on your website, or alternatively you can choose to have this DubLi logo instead?

 

Further Comments or Instructions: