Marketing Strategies That Build Your Business Email Welcome! Please take a moment and enter your business information into this form. These are all questions that I would ask you in a new client meeting and your answers will directly impact my ability to successfully market your business, products and services. This form saves us both time and ensures accuracy. Client Information Prefix Mr. Mrs. First Name * Middle Initial Last Name * Suffix Jr. Title Phone * Phone Alt. Email * Business Information Business Name (Proper) * Type * LLC PLLC INC Phone * Company Email Business Address * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Select Your Industry * Retail Food Service Import/Export Contractor Non-Profit (501c) Legal Services Wholesale Supplier Real Estate Medical Printing/Publishing Marketing Agency Other Number of Employees * 1-5 6-10 11-15 16-20 21+ Years in Business * Family Owned Business? Yes No Doing Business As If you conduct business under a different name than stated above, enter it here. Business Description * Estimated Monthly Sales $1.00 Use the slider to define a sales estimate. Online Business Profile Company Website Information If none, leave blank Does your company currently have a website? Yes, I have full administrative control and access to the website Yes, we have someone that has administrative access to the website Yes, but I have limited or no administrative access to the website No Main Company Website If none, leave blank. Online Commerce * Yes No Do you currently sell your products or services anywhere online? (eg. Your website, Etsy, Amazon etc) Additional Websites If none, leave blank Additional Website URL Additional Website URL Additional Website URL Social Media Links If none, leave blank Facebook Twitter YouTube Pinterest Google+ LinkedIn Instagram Other Other Other Marketing Information Business Slogan Leave blank if none. Have you ever worked with a Marketing Consultant or Marketing Agency before? * Yes No I Currently Use These Marketing Platforms Website Social Media (Business Page) Social Media (Ad Campaign) Direct Mail Advertising (Publication) Email Marketing Pay Per Click (SEM) Other Estimated Monthly Marketing Budget $1.00 Use the slider to define a budget estimate. Billing Preferences Invoicing Method * Email Mail Frequency * Monthly Annually Payment Method * Check Credit Card Cash Client Perks We like to give perks to clients and celebrate milestones. If you would like to receive client perks such as gifts and kudos, fill out this section. Your Birthday Annual Holiday Enter your recognized annual holiday. Business Goal(s) Attachments Attachments can also be emailed to jbittnerdesign@gmail.com Attach Asset Files Add Files
