If you need assistance completing this form, call or text Drew: (512) 788-5332

PLEASE FILL OUT THE FORM BELOW

This intake form is for New Raise The Rep! customers only.

We will use the below information to create your systems and accounts for your new reputation marketing program.

Note: Business Name, Address, and Phone should match EXACTLY as it appears on your website and Google My Business listing.

[ * is a required field ]

"*" indicates required fields

CONTACT DETAILS

Your Name*

Your Email*

Your Phone*

BUSINESS DETAILS

Full Legal Business Name*

Public Facing Business Name (DBA, Business Nickname, if any)

Main Phone*

Address*

Is your Google My Business listing up to date? (i.e., Hours, Description, etc.)*

Yes

I don't have one / haven't claimed it

I don't know

Other

Company Marketing Email Address (to receive New Review Alerts)*

Do you have more than one location?*

YES (We will give you an additional form to complete for those)

NO (This is my only location)

Company Logos and/or Images (for Branding, Sign-In Forms, etc.)*

Drop files here or

Max. file size: 100 MB.

MAIN BUSINESS DECISION MAKER

Decision Maker's Name*

Decision Maker's Email*

Decision Maker's Phone*

PROJECT MANAGER FOR REPUTATION MARKETING

Is Project Manager same as Decision Maker?*

Yes

Project Manager's Name*

Project Manager's Email*

Project Manager's Phone*

EMAIL ALERT NOTIFICATIONS

Who will receive email alerts? (Check all that apply)*

Decision Maker from above

Project Manager from above

Additional Email(s)

List additional Notification Email(s) separated by commas*

How often would you like to receive your Reputation Reports?*

MARKET / INDUSTRY INFORMATION

What is your primary industry / niche?*

What is your secondary industry / niche?

In order of importance, what are the top 1-3 products or services you are focused on selling?*

Product / Service 1

Product / Service 2

Product / Service 3

Describe the customers you sell to or would like to sell to: (age, sex, income, likes, dislikes etc.)*

Name 3-5 things about you / your company that make you unique in the marketplace / better than your competition:*

COMPANY ONLINE INFORMATION

Do You Have A Company Website?*

Yes

Company Website URL*

Do You Have A Company Blog?*

Yes, it is separate from my website

Yes, it is part of my main website

Company Blog URL*

Social Media Monitoring

Provide links for all of your company's social media properties, if you have them:

Company Facebook Page URL

Company Google My Business listing URL

Company Yelp URL

Company Instagram URL

Company Twitter URL

Company YouTube Channel URL

Company LinkedIn Page URL

Social Media Marketing

You will receive an email from us to connect your social media accounts from your computer / phone.

How often would you like us to post your Reviews to your social media accounts? (Facebook, Twitter, Instagram, etc.)*

Public Directory Listings

Are there any known online directories that your business is already listed in that you have the links to? (i.e., Home Advisor, Avvo, ZocDoc, Trip Advisor, etc.)*

Yes

Not sure

Provide your company's directory URL for each online directories that your business is listed in, each one on a new line (Ex.: your business' link / profile on Home Advisor, Avvo, ZocDoc, Trip Advisor, etc.)*

Are there any industry-specific directories you want to get new reviews on? (separate by comma)

DISPLAYING REVIEWS ON YOUR WEBSITE

Where on the company website would you like us to stream your reviews?*

Bottom Left of Homepage

Bottom Right of Homepage

Sidebar

Footer

On a new Reviews Page

On an existing Reviews Page

All of the above

Other (indicate below)

Other page

Who will place the Review Badge code and Tracking code on your website?*

Someone from my company (i.e., Webmaster, Project Manager, Decision Maker, etc.)

You guys do it, please (Raise The Rep! support team)

Enter the email address where we will send the code:*

Your website login URL*

Your website login Username*

Your website login Password*

MISC.

In order for our system to send emails to your customers from your chosen email address, we need to copy/paste a "record" into your domain's DNS. If you do this, we will send you the record. If you want us to do this for you, we need the login credentials for your website and/or hosting provider. Which would you prefer?*

I'll do it (or my webmaster)

You do it (Raise The Rep! support)

Provide the login details to your DNS provider (usually where you purchased your domain name, but it could also be your hosting provider or Cloudflare)*

Do you have a specific Terms of Service and/or Privacy Policy that you would like to use? (We provide them, if not.)*

Yes

Provide the link(s) to your TOS and/or Privacy Policy*

Email marketing consent*

I have permission to send marketing content to these contacts and confirm that these contacts are customers of my Company

Once your system is set up, we (or you) will import your contacts into your Raise The Rep! CRM. Please check the box to agree to the above statements.

SMS marketing consent*

I am importing a list of contacts that have opted in to recieve SMS Text Messages. I understand that I can be fined up to $1500 per message if a contact has not opted in

Once your system is set up, we (or you) will import your contacts into your Raise The Rep! CRM. Please check the box to agree to the above statements.

Please provide any other names, contact information, or additional information you think may be helpful

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