Onboarding Form - White Label Packages Step 1 of 6 16% Agency Information Please fill out this form as completely as possible! All fields marked with a red star are REQUIRED FIELDS. Make sure to read through this entire form and to give us complete, accurate information about your client and their business. Who is your Account Sales Representative?*Please choose from the dropdown menuLane HoukMatt HenryWho is your Quantum Account Success Manager?*Please choose from the dropdown menuI don't have one assigned yetEvelynJanaJenYour First Name* Your Last Name* Email* Primary Contact Phone Number*Agency Name* Agency Email Address* Please enter the email address where we should send our white label ppc reports.Agency Phone Number* Associated Order Number* The first step in our process is to place the order for the product solution(s) desired. Once you pay for those products an order number is created. Please put that order number here in this field. Your Client's Company/Business InformationCompany Name* Name of your client's company for this campaignDate Company was Founded MM slash DD slash YYYY Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Main Company Phone*Please enter the phone number where we will forward all sales calls. Company Email* Please enter the email address where we should send form fills.Website Public Relations/Press Contact First Name Last Name Google MyBusiness Listing Link Business Slogan or Tagline Business Industry/CategoriesPlease tell us what business categories your company would fit into. What industry or industries best classify your business (ie. cosmetic dentistry, auto repair, chiropractor, manufacturer, etc)Sales ProcessDescribe your typical sales process to work with online leads. Example: Prospect Clicks on Ad => Prospect Fills out Web Form => Client Calls Customer Back.List Hours of Operation*For example M-F 9 am to 5 pm and Sat. 10-3 pmPayment Methods Accepted - Check All That Apply* Cash Check Visa Mastercard Amex Discover Paypal White Label SEO Company Description & Keyword Info This section is very important! The information collected here helps us determine the best keywords for your client's business/industry/niche so please be as complete as possible!What is the primary objective of this campaign?Give us a description of the business*For example what products or services are provided; how these products or services are delivered.Primary Media Contact / Author* Give us the Top 10 Keywords you think people will search for when looking for a business like thisThese are the keywords you think a prospect would search for in Google when looking for products or services your client offers.Describe the Ideal Customer for Your Client*Demographics like age, sex, marital status, income level, etc. are great but also include a short narrative of who the typical customer is so we can truly understand the target audience.What 2-3 things do you does your client do better than their competition?What are other cities/zip codes (within 10 miles of your business) that you'd like to rank for, other than your main city?*How many articles per month you need for the campaign? Topical content ideas and themes White Label SEO Account Login Information To create your client's business listings, we need to know the account info if they have an existing Gmail, Yahoo or Hotmail email account.Please provide any/all website admin credentials here including the login page URLLogin URL: UN: PW:Does the client have a Gmail Account?* Yes No Username* Password* Does the client have a Yahoo email account?* Yes No Username* Password* Does the client have a Twitter account?* Yes No Username* Password* Does the client have an Instagram account?* Yes No Username* Password* Do you have a Linked In account?* Yes No Username* Password* Does the client have Facebook page for their business?* Yes No If yes, please add [email protected] as an admin of the business page. Do you have your own Vendasta account to be used?* Yes No Do you have your own Signal Genesys account to be used?* Yes No If yes, please provide login information.Username* Password* Website Login InformationWebsite Username Password Attach the Company Logo and any other relevant images Drop files here or Select files Max. file size: 512 MB. White Label PPC Account AccessDo You Have an Existing Google Ads Account?* Yes No Adwords Account Access Please Provide Your 10 Digit AdWords Account NumberWebsite Admin AccessPlease provide admin access to the website back end so we can set up call and conversion trackingDNS / Domain AccessPlease provide the user/password to the domain DNS so we can set up subdomains for landing pages if necessary.Do You Have an Existing Call Tracking Service?* Yes No Call Tracking AccessPlease provide the url and user/password to your call tracking account so we can set up call tracking numbers.If no, would you like to add-on CRM and Call Tracking for $100?*YESNO Budget / ServicesMonthly Ad Spend BudgetPlease enter your budget for monthly ad spend, not counting the management fee. Products and ServicesPlease list your main products or services. What is Your Most Profitable Product or Service?Please describe your most profitable product or service.KeywordsPlease enter a handful of keywords you think your prospect would enter to find your products or services.Promotions or Specials?Ads with pricing and special offers are significantly more successful. Are there any promotions or specials you want to specifically focus on in the campaign? $25 Off Your First Service Etc? White Label PPC Campaign TargetingAd SchedulingAre there any times during the day that you would like to either run or exclude ads? Please describe below. Example: Please run ads only during regular business hours, M-F, 9 am - 5 pm.Geographic Targeting IncludeAre there any areas or zip codes you want to specifically INCLUDE in the campaign?Geographic Targeting ExcludeAre there any areas or zip codes you want to specifically EXCLUDE from the campaign?Demographic TargetingAre there any demographic you want to specifically include or exclude from the campaign? Age? Male or Female? Would You Like Run Branded Campaigns for Your Company Name?Would you like to include or exclude your company name from keyword searches? We recommend INCLUDING your business name in searches. Include Brand Name Exclude Brand Name Would You Like To Bid on or Receive Clicks For Your Competitor's Names? Include Brand Name Exclude Brand Name Would you like to include or exclude your competitor's name from keyword searches? In most cases, we recommend EXCLUDING your competitor's name in searches.Please List Your Competitors Here: Landing Page InformationLanding Page Special Requests?Do you have any landing page special requests? (Add badge, use specific reviews) Please list them here.Landing Page Form FieldsWe include the following fields in the form used on the landing page: First Name, Last Name, Email, Phone, Zip Code. Would you like any field to be added or removed?CAPTCHANameThis field is for validation purposes and should be left unchanged.