New Client Setup Form

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If Information Is Unavailable Please Mark Fields NA or Unknown

Company Name

First Name

Last Name

Address

City

State

Zip Code

Local Phone - can not be a tracking number.

Email

Website

Company Email address

Number of employees

Year of company formation

Marketing Package

If Information Is Unavailable Please Mark Fields NA or Unknown

Please Give the following Email Address seo.outreachlocal2@gmail.com Access For Each Account:

Google My Business(Manager)
Google Analytics(Edit)

Google Adwords Acct Number So We Can Request Manager Access

Facebook Page URL We Will Request Manager Access

If You Cannot Do The Above Please Give Us The Following Information

Google Account Login (usually a Gmail)

Google Account Password

Initial Google Adwords monthly budget:

Cell Phone Number Attached to Google

Facebook Account Login

Facebook Account Password

Yelp Account Login

Yelp Account Password

Initial Facebook Ads Monthly budget:

Twitter Login

Twitter Password

If Information Is Unavailable Please Mark Fields NA or Unknown

Website Account Login (Wordpress)

Website Account Password (Wordpress)

Website Hosting Account/Cpanel Login

Hosting/Cpanel Password

Website Domain Company

Other Website Domain Company

Website Domain Login Username

Website Domain Password

If Information Is Unavailable Please Mark Fields NA or Unknown

What Payment Methods Does Your Company Accept From Your Customers?

I authorize Outreach Digital Marketing to charge the agreed amount, on a monthly basis, to my credit card provided herein. I agree that I will pay this purchase in accordance with the issuing bank cardholder agreement.

Credit Card Number

Expiration Date: XX/XXXX format

CVC

Billing Address

Cardholder - Name

Date

Signed

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