WestUSA Realty Website Purchase GET STARTED Upgrade your current website or sign up for a new paid website. Contact InformationName* First Last Phone*Email* MLS member ID*Region / MLS*Please ChooseFlagstaff (NAAR)Payson (CABOR)Phoenix (ARMLS)Prescott (PAAR)White Mountains (WMAR)Website InformationChoose a Package*Silver - White Theme - $298Silver - Black Theme - $298Gold - Cielo Theme - $498Gold - Denali Theme - $498Gold - Jinger Theme - $498Gold - Mont Blanc Theme - $498Gold - Pinnacle Theme - $498Gold - Prime Theme - $498Gold - Rainier Theme - $498Platinum - Bianco Theme - $1098Platinum - Capitan Theme - $1098Platinum - Regal Theme - $1098Platinum - Viso Theme - $1098Includes setup fee and first monthFacebook URLInstagram URLLinkedIn URLTwitter URLYoutube URLLogoAccepted file types: jpg, gif, png.Personalized/Team logo to be included in the website banner. This is ideally a transparent PNG.HeadshotAccepted file types: jpg, gif, png.A small headshot image for the top of your website. Please submit a JPG.TaglineBioDomain InformationWhat is the Domain (URL) we'll be using for your site?If you don't have a domain name please purchase one here: http://domainwithresults.com/ and enter it above.RegistrarWhere did you buy your domain name? Ex: Godaddy, Network Solutions.Registrar UsernameUsername to where you purchased your domain nameRegistrar PasswordPassword to where you purchased your domain nameBilling InformationBilling Name* First Last Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Billing Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Payment Agreement* I Agree Unless otherwise stated herein, you understand that by completing this form a charge to your credit card will be ran for the initial upfront payment and your monthly payments (as described above) will start 30 days from completing this form.Total $0.00 This is the amount that will charge once this form is complete. This amount should reflect your initial set up fee and first month of service if applicable.