Be sure to read the rules before applying.
If any of the info is missing, or the secret word is wrong, you won’t be accepted.
If you don’t hear from me in a week please contact me via mail directly, the form might not be working.
(*) it means it’s required stuff so you MUST fill those fields.

Admin Note: a send button seems to be missing from the form, but after you fill it out and reach the Secret Word part, if you hit enter on your keyboard it will send the order in. While I try to find a better replacement that will do, thanks.



Paying Currency USD (Any country outside the European Union)
EUR (Any country inside the European Union)
GBP (Any country from the United Kingdom)

Site URL *

Site Name *

Package *

WordPress Sidebar

Coppermine Sidebar

Images (urls only no .zip files – preferably HQ photoshoots) *

Scheme colors *

Do you prefer any specific color to be or not to be used?

Welcome Message (optional)

Disclaimer * (obligatory for wordpress: write "default one" if you want me to write it for you)

Advertisement banners (For Free Hosting. Add link where to find codes & how many you need.) *

Your Hosting (link to it please)

Anything else (be very detailed: header size, any special text to add, or image or reference, latest images in header, specific fonts to use)

Secret word (you NEED to read the rules) *

Created with Freedback online form.