Helping local and small businesses develop and grow their online presence

Local SEO Questionnaire

Please complete & submit the form

Welcome

Thank you for your interest in our local SEO business listings/citations service. This form was created in order to gather information about your business to be used in creating online business listings/citations as well as contacting the project lead, whether that be yourself or one of your valued employee(s), to work along with us, and receive updates and support. Please take your time answering ALL questions and be as detailed as possible. Your involvement will be required along the way including submissions that require you to verify your business phone number.

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Field is required!

Before we begin, let us explain a little bit how we work:

  • All local business listings are manually submitted.
  • We specialize in local business listings/citations geared towards your needs and industry type.
  • We will do our best to remove duplicate listings and update/correct your NAPs (Name, Address & Phone).
  • We also do not guarantee successful removal of listings. We are reliant on website editors to complete the removal of a listing as we do not have control over website editors and their editorial policies.
  • Submissions are typically completed within 2 - 4 weeks after payment.
  • We look forward to helping you increase your online local presence.
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Field is required!

Business Listing Information

Location Details

Location Name / Business Name*
Real world business name
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Address Line 1*
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Address Line 2
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City*
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State*
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Zip*
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Country*
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Business Details

Business Category*
(i.e. Computer repair, HVAC contractor, lawyer, etc.)
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Business Phone Number*
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Website URL Address*
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Unique Location Reference
(i.e. store ID, location code, etc.)
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Field is required!

Contact Details & Project Lead

Business Contact Details

Enter contact details you want to be displayed on your business listings
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Field is required!
First Name*
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Last Name*
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Email Address*
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Phone*
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Fax
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Mobile Phone
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Project Lead / Contact Person Info

Contact details below are used for us to directly contact you or the project leader
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Field is required!
Project Lead First Name*
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Field is required!
Project Lead Last Name*
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Field is required!
Project Lead Email Address*
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Field is required!
Project Lead Phone*
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Project Lead Mobile Phone
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Additional Contact Person(s)
Please include phone numbers and email addresses
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Field is required!

Additional Business Details

Staff and Foundation

Number of Employees*
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Year Business Established*
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Hours of Operation

Sun*

Closed
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24 hrs
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Start
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End
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Mon*

Closed
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24 hrs
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Start
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End
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Tues*

Closed
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24 hrs
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Start
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End
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Wed*

Closed
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Field is required!
24 hrs
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Start
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End
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Thurs*

Closed
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24 hrs
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Start
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End
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Fri*

Closed
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24 hrs
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Start
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End
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Sat*

Closed
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24 hrs
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Start
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End
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Accepted Payment Methods

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Business Descriptions

Short Description

Tell Us About Your Business: Short*
Please provide a short overview of your business. What do you do or produce?
(200 characters max)
Field is required! 200 characters max!
Field is required! 200 characters max!

Extended Description

Tell Us About Your Business: Extended*
Please provide an extended overview of your business. What do you do or produce?
(500 characters max)
Field is required! 500 characters max!
Field is required! 500 characters max!

Services / Products

List Five (5) of Your Services / Products*
1)
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2)
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3)
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4)
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5)
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Enter Additional Business Categories, If Any
1)
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2)
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3)
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4)
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5)
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Logo & Photos

Company Logo

Upload Your Logo*
Only jpg, jpeg, png, gif, and pdf file formats accepted
(10MB max)
Upload logo...
Please upload your logo!
Please upload your logo!

Location Photos

Upload Photo(s) of Your Location (up to 3)*
Only jpg, jpeg, png, gif, and pdf file formats accepted
(30MB max)
Upload photos...
Please upload at least one (1) photo!
Please upload at least one (1) photo!

Summary

Before submitting your data..
  • Please review each question and page for accuracy.
  • Make sure you have answered all questions and completed the whole form with as much detail as possible.
  • Project lead / contact person will receive a copy of this form via email.
  • We will review your submission as soon as possible and will be in touch.
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Field is required!
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Note: This form saves your progress on your current device and you may come back later to finish.
C
learing your browser cache / cookies will delete your progress.
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If you have any questions, please give us a call at (872) 215-2226

Contact Us

Start your path to success today!

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