Rep Local Marketing Questionnaire

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Primary Contact Name*
First and Last name of the main contact person that Rep Local should contact for this campaign
First Last
Primary Contact's Title
What is the primary contact's Title (position/ role) in the company?
Contact Email address*
Enter Email Confirm Email
Business Data
This information will be used to create, correct & manage your business listings across the web.
Business Name*
The official name for your business that your customers recognize. This is how it will appear on your listings.
Business Address*
This should be the physical address of your business. Do not use a PO Box, as it is against Google's terms to service.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone*
Your main business phone number.
Business Fax Number
Please list any other business phone numbers or tracking numbers
Are there any other phone numbers that have been used for your business in the past, including old numbers, extra numbers, back lines, etc. If so, please list them here
Business Website*
If you do not have a website, please enter NONE.
Business Email (public facing email)*
Please list your public email (if applicable) that can be used in your business listings online.
Hours of Operation*
Your open hours must be consistent across the web and your website.
List all languages spoken at business
Business Category(s)*
List up to 3 business categories, starting with the most important one.
What are the most important keywords or phrases you want to show up for when people search Google?*
List up to 3 keyword phrases. For example, a dentist may want to be found when people search for "dentist" or "cosmetic dentist". An mortgage lender may want to show up for "mortgage broker."
Nearby Landmarks or Popular Attractions
Including nearby landmarks within location pages and listings may provide a boost to your search rankings. Only list the ones nearby.

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Common Business Names
List variations of your business name that others refer to you as, or other ways your business may be listed online (now or in the past).
Previous Old Business Names
List previous or old business names that have been used in the past (prior to a business name change).
Your Business Slogan or Tagline
Company Description*
Please provide a complete company description.
Your business starting date*
What exact date was your business founded? If you don't have the exact date, please provide the month and year was this business founded.
List of your primary Products and Services*
Please specify your products or services in order of priority
Are there any Brands you sell?
Please list specific Brands you offer, sell or use (if applicable).
What makes your business unique or better than the competition. Why should people choose you?*
Do you specialize in anything more than your competitors? If so, please explain.
Who are your Top 3 Competitors?
List your top competitors. You can do a Google search for your most important search phrase you want to be found for, then see which competitors show up at the top.
Who is your target customer?
Describe your ideal customer/ patient/ client, including demographics such as age, gender, socioeconomic status, etc.
What is the target service area you want to draw customers from?*
List the city(ies), zip codes, radius around your business location, and service area details here.
List key people in your company, including their title.
Anyone who needs to be visible online or might be connected to your company online. For example: owners, doctors, lawyers, etc.
Please list any Associations or Licensure organizations you belong to.
If applicable, include any identification number that needs to be publicly displayed (MLS #, etc.)
Please list any events, teams, clubs, charity or non-profits your business sponsors.
Also list any additional involvement you might have with them.
Payments Accepted*
List types of payments you accept, including cash, check, types of credit cards, etc.
Insurances Accepted
If you are a business or practice that accepts insurance payments, please list insurances you accept.
Additional Information or Promos
Are there any other perks or benefits or specials you would like us to mention or promote online (free parking, valet parking, coupons, promos, happy hour, etc.)

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Account Access Information
We may need to access your key profiles and social accounts in order to monitor/ post and to integrate with our systems.
"Google My Business" account login and password?
This would be the master admin account of your "Google My Business" page. Please provide your email username, password, and any security answers needed for the account.
"Google Analytics" account login and password?
This would be the master admin account of your "Google Analytics" page.
"Google Search Console" account login and password?
This would be the master admin account of your "Google Search Console" page.
"Google Tag Manager" account login and password?
This would be the master admin account of your "Google Tag Manager" page.
"YouTube" account login and password?
This would be the master admin account of your "YouTube" page.
Your Business's YouTube Channel URL, plus up to 5 YouTube video URLs.
List one URL per line, please.
Your Business's Facebook Page URL
If you do not have a Facebook Page for your business, let us know if we should create one for you.
Your Business's Twitter profile URL, login username and password (if applicable)
If you do not have a Twitter account for your business, let us know if we should create one for you.
Bing Places for Business login (email & password) if applicable
This is often a microsoft account login. If you do not complete this field, we assume you do not have one yet and may have to create one for you.
Yelp Business Account login (email & password) if applicable
If you do not complete this field, we assume you do not have one yet.
LinkedIn login (email & password) if applicable
If you have a LinkedIn Company page, please provide the login info for the account that manages it. If you don't have a LinkedIn company page and would like us to create one for you, please provide the login info for the LinkedIn personal account to create it with.
Additional Account Logins (social sites, review sites, or directories)
Please list all site/ profile logins not listed above. Include the site name, along with the username/ email and password. Examples: FourSuare, Pinterest, CitySearch, Yellow Pages, BBB, etc.
Website Access Information
This next section is important so that we can fully audit and optimize your website. Please do your best to provide us with this information.
Website admin access
If your website is built on a content management system such as WordPress, Joomla, Drupal, Wix, SquareSpace, Weebly, etc., we will need your Admin login information: Login URL, Username/ Email, and Password. If you don't have this information, please contact your webmaster or website administrator.
cPanel (Control Panel) or FTP Access
Login URL, Username/ Email, and Password. Your webmaster or website administrator or hosting company should be able to provide this information to you.
Your Logo (Please upload)
Please upload your original logo file(s) (best quality) from your designer. This will be used when building your business listings online.
Drop files here or

Accepted file types: jpg, png, psd, eps, ai, gif, Max. file size: 5 MB, Max. files: 3.
Email
This field is for validation purposes and should be left unchanged.

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Step 1 of 3

Business Data

Account Access Information

Website Access Information