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PPC Client Intake Form
In order to provide you with the highest quality content for your website, blog, press release or other application, please complete the following form with as much detail as possible.
Business Information
Business Name
*
Business Address
*
Street Address
Address Line 2
City
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District of Columbia
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New York
North Carolina
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Northern Mariana Islands
Ohio
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Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
General Information
Website URL
*
Monthly Advertising Budget
*
-Select-
$500
$750
$1,000
$1,250
$1,500
$1,750
$2,000
$2,250
$2,500
$2,750
$3,000
$3,500
$4,000
$4,500
$5,000
$5,500
$6,000
$6,500
$7,000
$7,500
$8,000
$8,500
$9,000
$9,500
$10,000
$11,000
$12,000
$13,000
$14,000
$15,000
$15,000+
This amount represents the dollars you're spending on advertising, and does not include any management fees.
Geographic Target Market
Please complete as much of the following information as possible.
Targeted Country
*
Targeted State
Targeted City
Targeted City Radius
Enter the radius in miles around each city you wish to target.
Additional GEO Target Comments
Primary Products & Services
1st Priority Product/Service
*
2nd Priority Product/Service
3rd Priority Product/Service
PPC Campaign Direction
What type of campaign are you interested in launching?
*
Paid Search (text ads in search results)
Display Ads (banner ads on 3rd party websites)
Both (display & search)
Not sure
List of Primary Targeted Keywords
*
Separate tags with commas
Separate with comma. For example: Restaurants in Rochester, Restaurants in Utica, etc.
Keyword Modifiers
Separate tags with commas
Seperate with comma. For example, Diners in Rochester, Diners in Utica
Competitor's Websites
Please list 3 competitor's websites within your geographic target market.
Do you prefer to run your campaign 24/7?
Yes
No
Please list days/times you prefer your campaign to run if not 24/7.
What do you consider a conversion? Which type of conversion is most valuable to you?
We just want traffic
Make a purchase online
Fill out a contact form
Downloads
Phone call
Location Visit
Other
Other Conversion Type
*
What is the value of your average customer?
What is the average value of a lead?
How much are you willing to spend to acquire a lead or sale?
For Display Network Campaign
Please provide a list of sample websites you'd like us to target.
Target gender
Male
Female
Both
Interests you want to advertise
For example: Sports, Food, Golf
Adwords Account Access
Google Adwords Customer ID
Username
Password
Google Analytics Access
Username
Password
CMS Access
URL Address
Username
Password