Thank you for deciding to have your website with Wellsites. We are overjoyed to have you with us, and we hope you will enjoy using the many great features that you will discover your Wellsites have to offer.

Please fill in the form below and we will respond to you within 1 working day.

Many thanks for your decision in choosing Wellsites

The Wellsites Team

YOUR DETAILS

Your Name (required):
Company Name:
What is your Company Description or tag line ?
Your Email (required):
Your Phone No (required) :
Do you have a promotional code ?
How did you hear about us?
If Other or Personal Referral, please specify:

YOUR BILLING ADDRESS

Please enter your Billing Address

Address (required):
Zip/Post Code (required):
City (required):
State/County/Region(required):
Country (required):

WEBSITE DESIGN

Which website design from our gallery do you require? (if you are having a customized design please enter CUSTOM)

Design Name:

DOMAIN NAMES

Do you have a Domain Name (required)?  Yes No
If yes, please tell us your Domain Name (optional) :
If no, do you need help with registering a Domain Name (optional):  Yes No

EMAIL ACCOUNTS

As part of your package we will set-up 3 email addresses. Please give us details & password for these accounts:

First Email (e.g. yourname@yourdomain.com):
Password for First Email:
Second Email (e.g. info@yourdomain.com):
Password for Second Email:
Third Email (e.g. sales@yourdomain.com):
Password for Third Email :

LOGIN DETAILS

You will have access to update your website using a content management system.

Please provide us with your preferred username and password for this:

Login :
Password:

PAYMENT OPTIONS

Set-up Fees

The set up fee is payable upfront. Do you prefer to pay this by:

 Bank transfer (our preferred option - Australian residents ONLY) PayPal Invoice (you can then pay this by credit card or PayPal)

Hosting and Support fees

Annual payment

Save 10% on your monthly hosting and support fees.

If you pay your monthly fees annually we offer a 10% discount ($270 instead of $300).

 Annual payment of hosting and support fees - Bank transfer (our preferred option - Australian residents ONLY) Annual payment of hosting and support fees - PayPal Invoice (you can then pay this by credit card or PayPal)

OR

Monthly payment

$25 per month

 Monthly payment of hosting and support fees - Bank transfer Monthly payment of hosting and support fees - PayPal Invoice (you can then pay this by credit card or PayPal) Help! Please contact me to discuss payment options

TRAINING CALL

On completion of your website build we provide a training phone call (approx 30-60 minutes).

Please can you let us know your preferred days and times below:

Preferred days:
Preferred times:

ADDITIONAL OPTIONS

Do you want to know more about any additional services (available at additional costs):

 Customized website design Logo design, business stationary design and branding Website text (webcopy review) service

Any further details:

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Thank you for taking the time to complete this form.

We will get back to you within 1 working day.

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We are the award the award winning website designers to health care and wellness professionals. We offer a whole range of services from off-the-shelf templates to full custom designs. We provide an easy-to-use content management system to allow you full control of over your web content without knowing anything about the web.
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