Local Marketing Intake Form -

Published Business Name*

Please enter name exactly as you'd like it to appear on all local directory listings.
Main Business Phone*
This is the number that will be listed on the directory listings.
Primary Business Address*
Street Address Address Line 2 City State ZIP Code
Website

List the web address for this location.
Location Primary Email Address*

Enter the main email address where customers should contact your business.
Is there more than one location?*
- Yes
- No
Second Location Address*
Street Address Address Line 2 City State ZIP Code
Phone for 2nd Locatioon*
Website for 2nd Location

If this location has a seperate website address than the first location, please list that here.
Email Address for 2nd Location

Enter the email address where customers should contact your business for this location.
Add Another Location?*
- Yes
- No
Third Location Address*
Street Address Address Line 2 City State ZIP Code

If you have more than 3 locations, please email the remaining locations to your project manager.
Phone for 3rd Location*
Website for 3rd Location

If this location has a separate website address, please list it here.
Email for 3rd Location

Enter the email address where customers should contact your business at this location.

Description Summary of Business
We will edit this if necessary, but this should include 2-3 sentences, and include selling points for the business.
Payment Methods You Accept*
- Cash
- Check
- Visa
- American Express
- Master Card
- Discover
- PayPal
- Bitcoin
- Other
Hours of Operation*
Location Email

Enter email for each location if there are multiple email addresses.
Attach up to 10 images for inclusion in your directory listings.
Drop files here or

Max. file size: 50 MB.
No transparent backgrounds.
Company Logo
Max. file size: 50 MB.
Should be a high resolution image with a solid background. No transparent backgrounds.

Local Marketing Intake Form