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Digital Data Collection Form
Digital Data Collection Form
Justin Ferguson
2021-01-30T19:17:00+00:00
Digital Data Collection Form
General Information
Select Your Digital Product
*
OPTIMA
CloseBy Text Marketing
Sales Rep Name
*
Sales Rep ID
*
Customer #
*
Claimed Business Name
*
Claimed Business Address
*
Street Address
Address Line 2
City
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
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Business Phone #
*
Public Mobile Phone #
Private Mobile Phone #
Fax #
Website
Public Email
suppress address
Suppress address where possible
Business Category
*
Text Program Information
EIN #
*
Legal Business Name
*
Website
*
Potential Keywords
Promotional Materials
*
Signs
Stickers
Claiming Site Information
Choose Your Sites
Baseline receives 5 sites, Comprehensive receives 5 sites and Premium receives 8 sites.
Google
Yelp
Manta
MerchantCircle
FourSquare
Apple Maps
Bing
Chamber of Commerce
TripAdvisor
NextDoor
Products
Products1
*
Products2
Products3
Products4
Services
Services1
*
Services2
Services3
Services3
Hours
*
Monday - Friday Opening Time
Monday - Friday Closing Time
Hours
*
Saturday Opening Time
Saturday Closing Time
Hours
*
Sunday Opening Time
Sunday Closing Time
Year Established
Slogan
Areas Served
City, State or County, State
City, State or County, State
Payment Forms You Accept
Select All
Visa
MasterCard
AmEx
Discover
PayPal
Personal Checks
Debit Cards
Cash
Apple Pay
Android Pay
Help us Write a Great Business Description
How/Why did you start your business?
What makes your business special?
Future Plans
I look forward to growing my business to continue to serve...
I look forward to adding locations to serve more customers in the area....
I look forward to adding more products/services to better serve our community...
Expand on your future plans
+Social Questions
What should the 1st Post be?
*
Use Business Description
New 1st Post Idea
N/A
Please Include Your 1st Post Idea here.
*
We will post this to the Business's Facebook Page as AMP when we have access.
Additional Post Ideas
Call to Action
Book Now
Get Quote
Contact Us
Send Message
Call Now
Sign Up
Send Email
WhatsApp
Watch Video
Learn More
Shop Now
See Offers
View Gift Card
Order Food
Use App
Play Game
Reason for purchasing OPTIMA
Poor visibility under your business category
Out dated, poor quality, or unauthentic photos
Incorrect hours or services
Wrong phone number, address, or map location
Poor ranking against your local competitors
Unfair reviews, no review, or few reviews
No time or personnel to keep your business listings or profiles "fresh" with relevant new updates, pictures, and seasonal content
Google or Apple Maps pointing customers to incorrect location
Multi-location
New business
New location
Name Change
Other
Other Reason
Do you have an existing Facebook page?
*
Yes
No
N/A
Do you have access?
*
Yes
No
N/A
Notes
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