Geographic Marketing

DATA ENTRY FORM

Please Enter Your Information:
*Mandatory
 
Business Name *
Other/Corporate Name
 
 
Contact Name
Description (200 character max)
 

Local Telephone Number (Area Code + Phone Number)
(Enter up to 12 digit Numbers)
 
Main Phone *
Alternate Phone
 
 
Facsimile
Mobile Phone
 
 
Email Address *
Email Name
 
 
Address Line 1 *
Address Line 2
 
 
City *
State *
 
 
Zip Code *
Country *
 
 
Products
Brands
 
 
Specialties
Areas Served
 
 
Professional Associations
Year Founded
 
 
Language Spoken


 


Website and URL addresses
 
Business Home Page
 
Video Link
 
Coupon Link
 
Social Network Link
 
Other
 

Photo Link:
 

Logo Link:
 

Your choices:
 
Categories
 
Sub-categories
 

Payment Type:

Amex
Yes No
Diners Club
Yes No
MasterCard
Yes No
Discover
Yes No
Visa
Yes No
Debit Card
Yes No
Store Card
Yes No
Cash
Yes No
Check
Yes No
PayPal
Yes No
Invoice
Yes No
 


Hours of Operation:
Stored as military time - 00:01 - 24:00

Monday Open
Monday Close
Tuesday Open
Tuesday Close
Wednesday Open
Wednesday Close
Thursday Open
Thursday Close
Friday Open
Friday Close
Saturday Open
Saturday Close
Sunday Open
Sunday Close
 
 

 
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