Intake Form -

LBI (Local Business Information)

Please enter as much information below as you can. We will use this information to create or improve your online listings. The lines with "*" are required.

Business Information
Company Name:*
Address:*
Street Address City State / Province / Region ZIP / Postal Code Country
Address 2: (IF)
Street Address City State / Province / Region ZIP / Postal Code Country
Phone:*
Fax:
Toll Free Number:
Website: (include http://)*
Profile Email / Web Mail / Business Email:
Business Type / Category:*
Products / Services:*
Products / Services:*
Business / Office Hours:

: Hours

Minutes
Payment Methods Accept [Highlight all that apply]:*
- Cash
- Cheque
- Debit Card
- Visa
- Master Card
- American Express
- Discover
- Diners Club
- PayPal
- Invoice
- Financing
- Travelers Cheques
- Euro Card
In Business Since:*
Primary Keyword / Tags:*
Business Description - Short (200 Characters Max):*
Business Description - Long:
Business Logo: Upload Here
Accepted file types: jpg, jpeg, png, gif.
Photos (Min 10 Photos): Upload Here
Section Break
Photo 1
Accepted file types: jpg, jpeg, png, gif.
Photo 2
Accepted file types: jpg, jpeg, png, gif.
Photo 3
Accepted file types: jpg, jpeg, png, gif.
Photo 4
Accepted file types: jpg, jpeg, png, gif.
Photo 5
Accepted file types: jpg, jpeg, png, gif.
Photo 6
Accepted file types: jpg, jpeg, png, gif.
Photo 7
Accepted file types: jpg, jpeg, png, gif.
Photo 8
Accepted file types: jpg, jpeg, png, gif.
Photo 9
Accepted file types: jpg, jpeg, png, gif.
Photo 10
Accepted file types: jpg, jpeg, png, gif.
Video URL (Try to give 5 Videos): url
Additional Information
Tag Line / Business Slogan:
Specialties (exclusive products, areas of expertise):
Cities Served / Counties Served / Areas Served:
Offers [ex. - 20% off all haircuts, Expires: Oct 15, 2017]:
Affiliations (BBB Member, Sites / Trade License#, chamber of commerce etc...): (IF)
Social Media Page URLs (Face Book, Twitter, Blog):
Owner Information
Name*
Position / Job Title:*
Owner / Contact Person Bio:
Owner / Contact Person Location: (IF)
Street Address City State / Province / Region ZIP / Postal Code Country
Owner / Contact Person Photo:
Accepted file types: jpg, jpeg, png, gif.
Wordpress Login info: username/password*
Google Business login and url:*
Note: Previous Business Name, Address & Phone for editing business: (If business was submitted many times by you or other SEO worker)

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