Rah Media Group Signup

1
Which listing package works best for you?* This field is required.Choose your desired Listing package
Essential Listing Package
Pro Listing Package
2
Name of Business* This field is required.Please provide the name of your business or store.
3
Primary Contact:* This field is required.Please provide the name of the person of contact managing the account.
First Name
Last Name
4
Primary Phone Number* This field is required.Please provide a reliable number that you may be contacted if needed. Your phone number will not sold, rented, shared or distributed.
Area Code
Phone Number
5
Primary Email* This field is required.Emails are verified to maintain email accuracy account communications made via email. Your emails will not sold, rented, shared, or distributed and only used for business communication.
example@example.com - Verification helps to minimize false email accounts.
6
Do you currently have an online presence?Do you have a corporate / business website?
YESNO
7
What URL would you storefront directed to?* This field is required.This can be a social media link, homepage to the practice and allows access to assets or needed information.
Ex. Copy and paste the URL of your dental practice.
8
Provide store highlights.* This field is required.Provide a minimum of 5 store highlights that you would like to include.
Huge
Large
Normal
Small
Ok
Ok
9
What is the primary and secondary dental service provided?* This field is required.Please provide what area of dentistry your practice fits under.
Beauty
Fashion
Health
Other
10
Upload Your Practice LogoIf you have a website we will try to get it from your website or social channel. We will place generic logo if you do not have one.
11
Choose the State Listing Network * This field is required.Please select the primary State your Practice resides.
12
Our Digital Services* This field is required.Choose one of our storefront services. Premium page 1 placements are limited to (24 slots) per state network.
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My Bag
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My Bag
Great Product Name
$20
Quantity:1
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
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State Network Listing
Essential Setup (one-time): $399.99Monthly Hosting: $50.00/month - SKU:RMG-ES | Pro Setup (one-time): $599.99 Monthly Hosting: $50.00/month- SKU:RMG-PRO.
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State Listing
Premium Listing -Page 1 (Limited Spots)
Premium Page 1 Featured Add-On+$50/mo. add-on (Page 1 only). No additional setup fee. Your monthly becomes $100/mo. total while Featured is active.
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Alabama
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
States
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Terms and Conditions* This field is required.Please read the terms and conditions.
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