BxB Template Site

Contact Information

Let us know who at your company we can contact.
Primary contact (company owner):*
First Last
Office phone:*
Mobile phone:
Email:*
Preferred contact method?*
Alternate contact?*
Is there an alternate contact who will be working with BxB Media directly to build the website and schedule the coaching calls?
Alternate contact:*
First Last
Office phone:*
Mobile phone:
Email:*
Preferred contact method?*
Billing contact:*
Who should BxB Media contact for billing-related communications?
Billing contact name:*
First Last
Billing contact email:*
Complete all required fields before continuing to the next page.

Company Information

We'll need some basic information about your company.
Company name:*
Website phone number:*
Primary company address:*
This will be used as the primary address in Google My Business.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Upload your company's logo:
Preferred file formats: AI and SVG.

Click here to learn more about preferred logo formats.
Accepted file types: ai, jpg, pdf, png, svg, Max. file size: 128 MB.
License Numbers
If your site needs to display license numbers please include the license number and description below:
Do you have a maintenance agreement?*
Upload your company's maintenance agreement:
Accepted file types: pdf, doc, docx, pages, jpg, png, Max. file size: 128 MB.
Financing
Do you offer financing?*
What company do you use for financing?*

Current Website
Do you have a website?*
Current website URL:*
Do you know where your domain is registered?*
Example registrars include GoDaddy and Network Solutions.
Your domain's registrar:*
Do you have the login information?*
Do not include your login information on this form. We will collect this information at a later time.
Your Web Coach will discuss this with you.

Forms

Forms offer a way for visitors to contact your company. Let us know which forms you would like included on your site.
Which forms would you like to include on your website?*
- Contact Form
- Request Estimate Form
- Request Service Form
Notification Emails*
Include the email address(es) you would like form submissions sent to. If more than one address, separate them with commas.
Service Area

Please list your top three service cities to show on your site:

If you are listing cities from multiple states please include the state abbreviations.
City #1*
City #2*
City #3*

Social Media
Which social media platforms (if any) do you want to include?*
- Facebook
- Instagram
- Twitter
- YouTube
- None
Facebook URL:*
Instagram URL:*
Twitter username:*
YouTube URL:*
Google My Business
Do you have a Google My Business profile?*
Is your business verified with Google My Business?*
Do you have your login and password for Google My Business?*
Do not include your login information on this form. We will collect this information at a later time.
Other

Use this area to provide us with any additional information regarding your company or website.
Notes

Contact Information