CBI Form CBI Form As part of your whirLocal package, we will help claim and optimize your directory listings in directories such as Google, Yahoo, and Bing. Filling out this form will allow us to provide all of these directories with exactly the same information. The more complete your information, the better we can serve you! Step 1 of 4 25% Company InformationBusiness Name* DBA Name This is what you want as the public company nameBusiness Address (No P.O. Boxes)* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Note: Google and other directories will sometimes send post cards or letters to your physical address with verification codes needed to claim your listings. If you do not receive your mail at your physical business address you will need to make arrangements with your post office to have the verification post cards and letters directed to your P.O. Box.Is your physical address the same as your mailing address?YesNoMailing Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Contact Name* First Last Enter the contact name at your business that we will be working with in regards to your online listings (e.g. the owner, marketing contact, etc.)Primary Contact Email* Enter email of primary contact at your business related to your online listings (Note: This is NOT the email address that will be entered on your listing -- it is for our purposes only)Public Company Email* Enter the main company contact email that should be associated with your online listing (e.g. email@example.com, firstname.lastname@example.org, etc.). If possible use an email address at your company's domain name rather than a Gmail, Yahoo, AOL, Hotmail or similar address type.Primary Company Phone*Enter the main LOCAL phone number for your business (no toll-free, Skype, call management or other numbers)Alternate Phone NumberEnter any alternate (e.g. office/Skype/etc.) phone number for your business.Toll-Free Phone NumberEnter a toll-free number if you have one.Fax Number Payment Methods* Cash Check VISA Mastercard Discover American Express Diners Club Financing Invoice Please check ALL types of payment that your business accepts from it's clients. This is NOT deciding what method you will use to purchase whirLocal.Describe your business*(Please limit to 200 characters)We will optimize what you put here into a good keyword based description.Products or Services OfferedThink of these like the yellow page listing categories. List as many as you like, we'll narrow it down to the top 5Languages SpokenEnter a comma-separated list of languages spoken at your business (e.g. English, Spanish)Brands CarriedEnter a list of product brands your business carries and wants mentioned on your listingProfessional Associations and MembershipsAssociation Memberships, Special Designations, License Numbers, etc.List any professional associations or memberships that your business has (e.g. trade associations, BBB, Chamber of Commerce, etc.) and any relevant account numbers for those organizations.Service Area RadiusHow far do you travel to service your clients (if applicable).Geographic Areas or Specific CitiesDescribe the geographic area(s) your business services (examples: "Entire Willamette Valley", "Portland", "Southern Oregon", "I-5 Corridor", etc.)Business / Office Hours*Year FoundedEnter the year your business was originally founded. Web Sites & Social Media AccountsPrimary Website*Keyword Phrases Commonly Used to Search for Your Products or Services on Search EnginesEnter a list of keyword phrases that people might use to search for your type of business online, and/or any keywords you are currently targeting in your online marketing/SEO campaigns (e.g. for a painting business you might list "house painting, house painter, salem oregon house painter, exterior painting, interior painting"). One per line.Social Media Accounts Facebook Fan Page Twitter LinkedIn Youtube Other Please list all your social media urls, one per line.e.g.http://www.facebok.com/mypage/http://www.twitter.com/#!/mypage/etc.Directory Listings Google Places Yahoo Local Bing Local Yelp Merchant Circle Kudzu HotFrog Judy's Book Insider Pages Citysearch Angie's List Please check each social networking site where your company already has a listing or presence, and then provide a URL link to your page on each service in the areas provided below.Have you already claimed your Google Places page?*YesNoIf not, please let us do this for you. As standard practice we will create new email accounts (that you will have full access to) so we are not using your personal account as we set these sites up. If you have already claimed your Google Places with an email account you use daily we will change the email address used by Google Places. Your privacy and security is important to us. Once changed to a new email we will remove your personal email login information from our secure system.Do you already have a Google Account that we can access and use?*YesNoIf you'd prefer to not give us access to your Google account, we can set up a new one for you to manage Google Places and related services.Google Username:*Google Password* Media FilesPlease upload the pictures, video and special offer details you wold like us to use when setting up your Google Places and other directory listings.Logo ImagePlease upload a logo for us to use on your directory listingsUpload PictureUpload PictureUpload PictureUpload PictureUpload PictureYoutube Video URLse.g.http://www.youtube.com/watch?v=kLa7MY0JHqUhttp://www.youtube.com/watch?v=qUa7MYkL0JHIf you have any Youtube videos, please paste the url's above, one per line.Would you like to offer a special "token of appreciation" for someone after they leave a review? If so, please put that offer here.*Be as creative as you like. Examples: Starbucks gift card (check out egift cards: https://www.starbucks.com/shop/card/egift for a super easy simple way to treat your raving fans.), 10% off next service or pin light for your key chain, hat or other item that can be picked up at your place of business.Would you like to have a special offer on Google Places? This helps your listing stand out. If so, please list that information here.*Ex: 10% off on 'product' through May 31stDo you have a customer testimonial to get us started? We will need this to complete your whirLocal engine. *e.g.NameCity/State Customer Review TextAdditional Instructions or Comments?Schedule TimeWe will need to schedule a time when you will be available by the phone for about 30 minutes to be able to confirm your listings with Google, Bing & Yelp. What is generally a good time in your day to do this?Time and Day*to coordinate Google Places, Bing & Yelp business listing: Day and Time (Monday - Friday, 9am - 5pm). Give us an idea what the best time of day and day of the week would be good to coordinate setting up the local directories.