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Customer #
*
Business Name
*
What is the customer's status?
*
Current OPTIMA customer adding Social
Current OPTIMA customer, upgrading to next program level and adding Social
Not an active OPTIMA customer
What program(s) is the customer purchasing?
+Social Only Packages
+Social AND Posting Packages
Posting Package Only
+Social added during Renewal window
*
Yes
No
OPTIMA Data Collection
Products
Services
Brands
Specialities
Year Established
Slogan
Payments You Accept:
Visa
Master Card
Amex
Discover
PayPal
Personal Checks
Debit Cards
Cash
Apple Pay
Andriod Pay
Certifications
Associations
Location Facts
Languages
5 Most Important Search Terms
Areas You Serve
Monday Hours
Tuesday Hours
Wednesday Hours
Thursday Hours
Friday Hours
Saturday Hours
Sunday Hours
Select Your Sites
*
Google
Yelp
Bing
Apple Maps
Facebook
Manta
Hot Frog
Yahoo!
Angie's List
TripAdvisor
MapQuest
YP
Merchant Circle
Four Square
Zomato
CitySquares
Chamber of Commerce.com
Select Your Program
*
Premium +Social
Comprehensive +Social
Baseline +Social
OPTIMA Program Amount
*
OPTIMA Program Amount
*
+Social Program Amount
*
Set Up Fee Amount
*
Posting Program Amount
*
Total Sale Amount
*
POS Amount
Total
*
$ 0.00
Facebook Questions
Do you have an existing Facebook Business Page
*
Yes
No
Do you or someone on your team have access to this page?
*
Yes
No
Call to Action Button
*
Call Now
Send Email
Learn More
1st Post Ideas
Yes
No
1st Post Ideas Description
*
Additional Notes
Sales Rep Name
*
Message
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