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(844) 244.0219

Home
About
Services
Works
Contact
- New Client Form
Blog
(844) 244.0219

Home
About
Services
Works
Contact
- New Client Form
Blog
(844) 244.0219

Home
About
Services
Works
Contact
- New Client Form
Blog
(844) 244.0219

New Client Information

We look forward to launching your new digital marketing campaign. The information provided below will help speed up our teams process in getting your business profile updated and visible to a larger local or national audience.

Please Complete to ensure processing

Primary Account Contact
First Name *
Last Name *
Email - Personal *
Date *
Phone - Mobile
Phone - Other
What services are you interested in? *
Search Marketing (SEO)Paid Placement (PPC)Web DesignBrandingEmail MarketingMarketing - Other

Business Information

Business Name *
Present Business Address *
Physical Location (no p.o. boxes)Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone Number (Local) *
Phone Number (Toll Free)
Phone Number (Other/Fax)
Email - Business Main *Forms, Contact Leads, Reply to
Email - Business Other Email List, Sales, Support, etc.
Do you have a website? *
YesNo
Is website/domain currently active? *
YesNo
If Yes, what is your website url ?
Hosting Company Who hosts your website?
Account Number or User Name
Domain Registrar GoDaddy, NameCheap, Etc.
Business Start Date *First day of business
Business Categories *Top 3 Categories to list your business. Separate by comma.
Top 3 Search Phrases *Ie: Pizza Delivery Near Me, 24 Hour Pizza Delivery, NY Style Pizza... Separated by commas.
Top 3 Products and/or Services Offered. Separated by commas. *

Target Market

Target Customer/Audience *
Please define your customer/audience or geographical target market.Local SearchU.S. OnlyU.S and Other Countries
Counties or Countries Serviced *
Cities Serviced (local seo) *Enter cities if you are focused on local search
GEO Target Radius Customer reach in miles and/or travel time.

Hours of Operation

Mon
Tue
Wed
Thu
Fri
Sat
Sun
Holidays - Closed

Social Media Accounts - Account Name / URL

Facebook
Twitter
Google +
LinkedIn
Instagram
Pinterest
Any Other Social Media
Mail Chimp or Mailer Program *
YesNo
Account User Name

Local Search Accounts - Account Name / URL

Instructions If you have set up any Local Search directories please provide Login/User Names and/or the URL's so we can locate and verify the listing information. We will request to be added to admin or you can add us manually. No Passwords Please!
Google My Business
Bing Places
Yahoo Local
Yelp
Apple Maps
Square

Testimonials

Legal Disclaimer

Disclaimer
I hereby authorize OTL Digital Media Group, LLC to utilize the information provided: Media Accounts access, References, Testimonials, Contacts, etc. for the purposes of setting up and managing our Online Digital Marketing Promotional Campaign and/or Website. I authorize persons and organizations contacted by OTL Digital Media Group, LLC to provide any relevant information regarding our current and/or previous online media presence, media accounts, hosting accounts, domain registrars. I release all persons, employers, employees of any and all claims for providing such information.
Signature *
Email *

Verification

Please enter any two digits *Example: 12
This box is for spam protection - please leave it blank

GET IN TOUCH

Toll Free: (844) 244.0219
Local: (904) 447.0889
Sarasota, FL 34240

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