The Intake Form will give us all the information we need to perform your SEO work effectively.
Please fill in every entry as each one has importance in ranking your website.
Do please enter as much information as you can. We use this information to create or improve your online listings.
Business Name: * Address: * Street Address City State / Province / Region Post Code Country
Address 2: Street Address City State / Province / Region Post Code Country
Phone: * Fax: Toll Free Number: Skype Number: Website: * Email:
Business Type / Category: * Products / Services: * Products / Services: *
Days of Week: *
MondayTuesdayWednesdayThursdayFridaySaturdaySunday Hours of Day: *
Highlight all that apply: *
CashBank DepositDebit CardVisaMaster CardAmerican ExpressDiners ClubPayPalStripePOLi Other payment methods:
In Business Since: * Primary Keyword / Tags: * Business Description - Short (200 Characters Max): * Business Description - Long:
Upload Your Business Logo Here: Business Photos (Minimum of ten - limit per file of 2mb): Upload Here Photo 1: Photo 2: Photo 3: Photo 4: Photo 5: Photo 6: Photo 7: Photo 8: Photo 9: Photo 10: Video URL's on YouTube, Vimeo, etc. (Try to give five Video URLs from say YouTube or Vimeo) Video 1: Video 2: Video 3: Video 4: Video 5:
Tag Line / Business Slogan: Specialties (exclusive products, areas of expertise): Cities Served : Language Spoken: Wi-Fi Available: YesNoN/A Parking Available: YesNoN/A Reviews: Testimonials: Coupons & Specials (Get more business by adding an offer or discount. You can update or delete your coupon at any time): Offers (for example: - 20% off all haircuts, Expires: Oct 15, 2013): Brand Names Carried: Affiliations (Member Sites / Trade License No., Chamber of Commerce etc...): Social Media Page URLs (Face Book, Twitter, Blog):
Name * Position / Job Title: * Owner / Contact Person Gender: *---MaleFemaleUnspecified Owner / Contact Person Date of Birth: * Owner / Contact Person Bio: Owner / Contact Person Location: Street Address: City: State / Province / Region: ZIP / Postal Code: Country: Owner / Contact Person Photo:
Website Login info: username/password * Google Business Login: * Google Business Url : *
Please create an email account e.g. [email protected] for us to use. Enter the name of the email account here:*
Any previous business Name, Address & Phone for editing business. (For example, if your business was submitted many times by you or other SEO company)