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Client Information Form
Fill out this website information form to help me get to know your company. I will use this information to construct your new marketing material, except for the contact and billing information which will always remain confidential.

Contact
Contact Full Name
Email
Phone
Mailing Address
City
State
Zip Code
Billing
Billing Contact Name
Email
Phone
Billing Address
City
State
Zip Code
Company Profile
Company Name
Company Email Address
Company Phone
Primary Physical Address
City
State
Zip Code
Mailing Address
City
State
Zip Code
What is your company all about and what kinds of products and services do you offer?
List any mentionable associations, partnerships, awards, or any other notable facts:
List important keywords, advertising keywords, and/or potential search phrases that might be used to search for your products and services online:
Social Profile
Insert the URL or type the username for the sites which your company already maintains accounts.
Facebook
Twitter
Google +
YouTube
Write any additional sites, including blogs, that your company has accounts for. If you are paying for a monthly social media marketing management contract, enter the login credentials for the websites below.

Selling Online*
Would you like to sell products or offer payment for services on your website?
  Yes         No
Approximately how many items or services would you offer?
Do you have item descriptions, prices, and other details for your inventory in a spreadsheet?
  Yes         No
Do you already have pictures of your inventory items?
  Yes         No
*Selling online will increase the cost of websites by at least $100.
Website Specifics
Only complete this section if you are paying for website development services.
If you need a custom domain name, list the domain names you would like to have with the one you want the most listed first. Custom domain names are subject to availability.
For new websites, list any color themes or design ideas that you would like me to consider. Please note that some design elements might greatly increase the pricing.


The contact form will allow a user to send a message to your staff sent to as many addresses as you would like. List recipient addresses in the boxes, separated by a comma.

To: CC:
BCC:   

The form also automatically sends an email to the person sending the email, a great opportunity to introduce your company and staff members, hours of operations, social pages, as well as provide an estimated response time to the sender's email.
Media
If you have any photos or videos that you would like for me to use, including any logos or marketing material, please email them to me at brandon@iadministrative.com.
Submit

By submitting this form, you agree that you have paid or intend to pay within ten (10) days
  • the $100.00 deposit required for website development contracts,
  • the first $65.00 reoccurring annual payment for custom domain name and limited website hosting plan
  • the $85.00 minimum payment for SEO content editing services,
  • or, the first $85.00 minimum reoccurring payment for internet marketing or advertising campaigns.