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Full Name *

Company Name *

What is the best phone number for customers to reach you? (We will be setting up a tracking number that forwards here) *

What is your best email for our lead communication? *

Your Facebook Page Link (If you do not have one please put “Need to create”) *

What is your current website link

What cities do you service? *

What are the main services you want to promote? *

Your Time Zone *

Full Business Address *

- Please list two area codes in case the first one is not available

Area code on the number we purchase - call tracking *

Are You Currently Advertising Your Business?

Yes

If yes, approximately how many new leads do you generate each month?

Offers/ promotions you have run in the past or thought about running

What Are You Most Interested In? (Check All That Apply)

More Leads

More Booked Appointments

More Business Automation

Ad Spend/month

Do you currently have any auto-mated replies set up for people who message your Facebook page?

Yes

Please provide the name, email, and phone number of the person who will have access to AppMind.

Any Additional Notes

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To buy the tracking number + sms credits