Facebook

This field is for validation purposes and should be left unchanged.

Business Name*

Enter the company's name

Alternate Business Name(s)

Any other names for this business?

Owner / Key Contact Person*

First Last

Business Address*

Street Address City State ZIP Code

Business Phone*

Primary Business Phone Number (for Public)

Business Phone 2

Additional Phone Number, if present.

Fax

Fax Number

Primary Contact Email (for PUBLIC)*

email ID to be listed on search engine portals.

Is the above email the REGISTERED email with Google?*

Yes
No

Google-registered email ID (** For Helix SEO **)

Email ID registered in Google for Google Maps and other Google related websites.

Google email ID Pwd

Company Website (Main)*

More than one website?*

Yes
No

Company's Website-2

Additional website

Company's Website-3

Additional website

Contact Phone Number (For Helix Use Only)

Key person's Contact phone number (NOT for Public)

Any Alternate Contact(s) for Helix SEO Purposes?*

Yes
No

Contact Person for Phone Verifications, etc. (** For Helix SEO **)

First Last

This will be the contact person, if the main contact person is NOT the one answering the phone calls for verification purposes.

Alt Phone Number for Phone Verifications, etc. (** For Helix SEO **)

Alternate Phone Number for Phone Verifications, etc. (NOT for Public)

Alternate Contact Email (** For Helix SEO **)

email ID of the Alternate Contact Person (NOT for public use)

Year Established

Year the company was formed / registered.

Number of Employees

Approx. number of employees in the company (if accurate info is not known).

More than One Location?*

Yes
No

Does the company has more than 1 location?

Additional Location1 (City, State)

Additional Location2 (City, State)

Industry

The industry of this business.

Affiliation with the following bodies:

Better Business Bureau (BBB)
Local Chamber of Commerce
Other - Nationwide Professional Association (any)

Membership organization(s) / Association(s)

Enter the name of the professional organization where this SEO client is a member.

More Detailed Info

Brief Intro about the company

Brief Introduction about the company (in 250 characters)

Products / Services

Enter the products and services offered by this company. Include any specific brand names as well. (Max: 400 Characters)

Top 3 Competitors

Keywords*

Enter the keywords identified in the order of highest to lowest. (one per line)

Serving Area (Geographic)

Neilson DMA Area
Nation-wide
Global

Areas being served (Geographic)

List the areas being served by this client (Free form text).

WP User ID / Password *** Office Use Only ***

*** (Helix SEO Internal use only) ***

Target Date (for the 1st batch SEO tasks)

Enter the anticipated target date for completion of SEO task for this client.

Remarks / Special Instructions

Any special handling or any additional information on this client.

Payments

More Detailed Info