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About Us
Our Services
FAQ’s
Design Request
Contact Us
Get In Touch
087 822 1178
info@konceptmedia.co.za
Block 4, 150 Rivonia Road, Sandton, Johannesburg
KONCEPT
MEDIA
design form
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give us an idea of what you want / need and we we will make it happen.
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Name
*
First
Last
Business Name
Email
*
Contact Number
*
Do you want to build a new website or redesign an existing one?
What are your products and/or services?
Does your company have branding guidelines?
Yes
No
Branding Guidelines:
Logo
Tagline
Images
Content
what guidelines do you already have ?
Purpose of the Website ?
eCommerce
Portfolio
Personal
Non-Profit
Business
Membership
Educational
Informational
Social Media
Other
Design / Project Goals
Promote new services
Establishing a brand
Improving company image
CMS platform
Sell products
Other
What features would you like to have on your website ?
Homepage
Shopping Cart
Image Slider
Video Streaming
Pricing Tables
Image Gallery
Newsletter
Customer Login/ Registration
Custom Forms
Maps
Blog
Social Media Buttons
Live Chat Option
Online Ordering
Search
Call-to-Action Buttons
Online Payment
Do you need help with blogging and content marketing?
Yes
No
Do you need help updating and maintaining your website?
Yes
No
Additional Services
Logo Design
Web Development
Image Optimization
Website Maintenance
Custom Illustrations
Custom Animations
Infographic Design
Application Design
Social Media Marketing
Flyer Design
Business Cards
Posters
what additional services do you need or may need in the future ?
What is your timeframe ?
Immediately / Yesterday
1 - 5 Working Days
1 - 3 Weeks
+ 1 Month
let us know your deadlines and lets work towards getting your work back to you as fast as possible
Do you believe in Aliens ?
Yes
No
Website Inspirations
Websites that have a similar feel / functionality. You want a similar look and feel and drawing inspiration from.
Approximate Budget:
Additional Comments or Information:
Submit
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