Customer Details:
Full Name
*
First Name
Last Name
Company Name
*
Type of Business
*
Healthcare, Real Estate, Non-Profit, etc.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Office Phone Number
*
(To Be Used in Campaigns)
Cell Phone Number
*
Where Do We Send Lead Text(s) Notifications to: (Can Be Multiple)
*
E-mail
*
example@example.com
Where Do We Send Lead E-mail(s) Notifications to: (Can Be Multiple)
*
example@example.com
Facebook Page Link
*
Instagram Page Link
*
Website URL
*
Office Manager's Name (To be Used in Campaign Follow Up)
*
Type of Campaign
*
Facebook/Instagram, Google
Ad Offer
*
What is the incentive for leads to click your ad?
Campaign Goal
*
Leads, Conversions, Awareness, Donations, Sign Ups, Page Growth, etc.
Daily Budget For Facebook Ads
*
Daily Budget For Google Ads
*
Audience Location
*
10 mile radius form office, zip codes to be included or excluded
Demographic You Want to Reach
*
Men, Women, Both
Target Age Range
*
How Did You Hear About Us?
*
Facebook, Instagram, Google, Friend, etc.
Provide 5 Bullet Points Describing Your Service/Product
*
1. 2. 3. 4. 5.
Notes or Anything You Need Us to Know About the Campaign
*
Submit
Should be Empty: