Marketing Information Gathering Form

Business Information:

Business Name (Inc. or LLC?)*

Business Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Contact Information

Contact Name

First Last

Contact Email*

Business Phone*

Business Fax

Business Website URL

Do you have admin access to your website?*

Yes
No
Not Sure?

If you do have admin access to your website, please enter your login web address, username, and password. (This is a secure form so your information will be safe.)

Website Admin Address (Example: Yourwebsite.com/admin)

Username

Password

Additional Business Information

Years in Business

Business Hours & Days

Payment Types Accepted

Credit Card
Paypal
Invoice
Cash
Check

Products or Brands Offered

Keywords

Add up to 5 keywords and locations for your business below, for example: “Tractor Parts” in “Dallas, TX”. The location can be a city, county, city+state or zip/postal code. If you do not enter a location, we will use the city listed in your address.

Keywords:

Advertising Area/Coverage: Cities, Zip Codes, Mile Radius, etc.*

Are you currently running paid ads on Google AdWords?*

Yes
No

If yes, please provide your Google Adwords account number.

Logo Files

Business Logo

Max. file size: 50 MB.

Existing Social Pages

Enter in the web URLs for your social media pages

Google+ - URL Address

Twitter - URL Address

Facebook - URL Address

LinkedIn - URL Address

Youtube - Link

Notes

Competition - List top 4 competitors and website adresses.

Questions/Comments?

Comments

This field is for validation purposes and should be left unchanged.