Web Site Features


This form will help us understand to some extent what you want to see in your web site. Changes can always be made at any time to accommodate the growth of your web site.

Your Information

First Name
Last Name
Business Phone
Mobile Phone

Web Site Preference

Extras will require a quotation and a followup discussion like how many items in shopping cart or store, will you be providing the description etc.

Enter a description eg. Business, Service Company, Restaurant, Construction, Music Store, Hair Salon, Bar
What is your Domain that you will be using?

If you do not want to bother with registering a domain or the yearly cost, you can use one of our subdomains as your website domain at no charge. This would be: "Yourname.mediahead.ca"