GOOGLE AD CAMPAIGN FORM Please fill out the following form so that we can get started on your campaign. Step 1 of 5 20% About Your BusinessBusiness Name* Business 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 FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Website URL* Sales Phone Number*Please enter the phone number where we will forward all sales calls. Lead Notification Email Address*Please enter the email address where we should send form fills. Describe Your BusinessSales ProcessDescribe your typical sales process to work with online leads. Example: Prospect Clicks on Ad => Prospect Fills out Web Form => Client Calls Customer Back. Account AccessDo You Have an Existing Google Ads Account?* Yes No Adwords Account AccessPlease Provide Your 10 Digit AdWords Account Number Website 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. Budget / Services Monthly 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? 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 Competitor Names Exclude Competitor Names 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?NameThis field is for validation purposes and should be left unchanged.