Business Information Form

Your Name (required)
Your Email (required)
Your Business Name
Street Address
City, Zip/Area Code & Country
Phone Number with area code
website address (if you have one)
By providing the additional information below we will be able to tailor very affordable suggested solutions to boost your online marketing results.
How happy are you with your current website?
Google Places  Not yet submitted Submitted but not optimized
Have you tried Google adwords Pay Per Click advertising?  Yes Not Yet
Do you have a system to gather customer testimonials?  Yes Not Yet
Do you have a system to gather customer email addresses?  Yes Not Yet
Do you have a mobile/SMS marketing system?  Yes Not Yet
Would you like a free one month trial including a free QR code barcode generated for your site that can be read by smartphones?  Yes Please No thanks
Have you tried loyalty programs or coupons?  Yes Not Yet
Have you tried Groupon or other Daily Deals marketing?  Yes Not Yet
Which accounts do you already have set up for your Business?  Facebook Page Twitter YouTube FourSquare Yelp
Google Account username/email
Facebook Page link
Twitter Account username
YouTube Account username
FourSquare Account username
Yelp Account link
Any other comments?
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