New Client In-Take Form

Video Package

Please fill out the form as detailed as possible. The more information you provide us, the better we can serve you. If you need any assistance filling out this form, please contact your Sales Rep.
What is your ultimate goal with Video Marketing?
(Brand Awareness, getting leads, website traffic, running an event, Sales Event)
List any Frequently Asked Questions by your potential clients
List of Things you want your clients to know
SEO Key terms
Who will be speaking in the videos?

First NameLast Name
Best time of day for scheduling the shoot?

:HourMinutesAM/PM Option
Date options for scheduling the shoot?

YearMonthDay
4 digit year, 2 digit month, 2 digit dayDate

SEO (Search Engine Optimization)

Please fill out the form as detailed as possible. The more information you provide us, the better we can serve you. If you need any assistance filling out this form, please contact your Sales Rep.
Desired Ranking Keywords
Desired Ranking Locations

Facebook Advertising

Please fill out the form as detailed as possible. The more information you provide us, the better we can serve you. If you need any assistance filling out this form, please contact your Sales Rep.
What is your goal for Facebook Advertising?
(Brand Awareness, getting leads, website traffic, running an event)
What age and gender is the majority of your customer base?
Do you run monthly specials that you would like to advertise?
Do you have an email list of your current clients?
We will not use this list to contact your customers. We use this information to create an audience to advertise your business too.
Please either paste the link to your customer list or attach a .XLS file below.
.XLS File Customer List

Browse Files

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Mobile Application

Please fill out the form as detailed as possible. The more information you provide us, the better we can serve you. If you need any assistance filling out this form, please contact your Sales Rep.
Which platforms would you like this app built for?
Application Name
Application Icon Name
Application Description
What is the purpose of this app? What key features are you looking for? What key benefits does this app provide to its users?
When do you need this application completed?

YearMonthDay
4 digit year, 2 digit month, 2 digit dayMinimum of 10 days is generally needed - Additional expedite fees MAY apply.
Application Style
How would you like this app to look? What colors, styles, or examples should we use as reference?
Application Keywords
Keywords help potential app users find and download your app. What keywords do you want listed on your app?
Application Category
Apps are organized in the marketplaces by category. What category would you like your app listed under?
Application Info URL
What URL do you want listed for when app users want to find out more about the company behind the app? This could be the main corporate site, a dedicated app site, an app support site, etc...
Is this application for a live event?
When is the event date?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Current Specials
Are there any current specials going on such as coupons, events, or sales? Let us know so we can add this into the application.
Application Requests
Do you have any special requests for functionality? What can you tell us to help us make the best app possible?
Fileshare Link
If you have images you'd like to have added to your app, you can simply and easily open a free file sharing account with DropBox, or a similar service. Please just be sure the file is set to share with anyone that has the link, then insert the link below. Also be sure to name each image file and let us know where we should be placing it within the app in the notes field below.
Additional Notes
Please use the notes section to put all information we will need to build the app. We will do one round of changes for free based upon your input after you have reviewed the app. Any requested revisions after that first round will incur a fee.
The following information is required for your application design.

The public phone, email and address will be used in the application and visible to the end user. This should not be your's or your contact's personal information, but rather the public facing email, phone number and address that customers should see and use.

Please note: A business website is required for any request put through. Without a full business website, your request will be reviewd by our intake team and accepted on a case by case basis, and may be subject to an additional fee.
Public Phone Number

Area CodePhone Number
Public Email Address
example@example.com
Public Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Content Writing

Please fill out the form as detailed as possible. The more information you provide us, the better we can serve you. If you need any assistance filling out this form, please contact your Sales Rep.
What will you be needing copy written for?
(Event, Website, Commercial, etc...)
What is the number of words you are anticipating you will need for your content?

CRM Development

Please fill out the form as detailed as possible. The more information you provide us, the better we can serve you. If you need any assistance filling out this form, please contact your Sales Rep.
Describe what types of flows do you need or are interested in?
How many employees will be using this CRM
Please list each employee email address that needs to be added to the CRM
Will you need to store any kind of information or files on your CRM?
What information or files will you need to store?
(Client Information, Order Information, Images, etc...)

Social Media & Listing Pages
Business Facebook Page URL
We will be sending a request for Admin access to your Facebook Business Page.
Business Google Listing URL
We will be sending a request for Manager access to your Google Listing.
Business Twitter Page URL
Business LinkedIn Page URL
Business Instagram Page URL
Business Youtube Page URL
We will need the Owner of the YouTube Account to add holly@h2msolutions.com as a Manager of the YouTube Page.
Yelp Listing URL

Contact Information

Please fill in the main point of contact for communication, the business owner's contact information, and billing information.
Main Contact Name

First NameLast Name
Main Contact Phone

Area CodePhone Number
Main Contact Email
example@example.com
Business Owner's Name

First NameLast Name
Business Owner's Phone Number

Area CodePhone Number
Business Owner's Email
example@example.com
Please provide the bill-to information for your business where we will be sending our invoices to.
Billing Department Contact Name

First NameLast Name
Billing Department Phone Number

Area CodePhone Number
Billing Department Email
example@example.com
Additional Details
Should be Empty:

New Client In-Take Form

Basic Business Information

Reputation Architect

Video Package

Text Marketing

SEO (Search Engine Optimization)

GEO Con-questing

Facebook Advertising

Mobile Application

Website Design Service

Branding Package

Content Writing

Email Marketing

CRM Development

Custom Graphic

Contact Information