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What is the customer's status?
*
Current OPTIMA customer adding Social
Current OPTIMA customer, upgrading to next program level and adding Social
Current OPTIMA customer, renewing program and adding +Social
Current OPTIMA Customer, Renewing +Social
Not an active OPTIMA customer
What program(s) is the customer purchasing?
+Social Only Packages
+Social AND Posting Packages
Posting Package Only
NEW OPTIMA +Social Program
OPTIMA +Social Program
*
Baseline +Social
Comprehensive +Social
Premium +Social
Did they purchase an additional Posting Package?
*
Yes
No
Posting Package Purchased
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12 Posts
25 Posts
50 Posts
100 Posts
+Social added during Renewal window
*
Yes
No
Customer #
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Business Name
*
Business Owner's Name
*
Claimed Business Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
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Indiana
Iowa
Kansas
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Louisiana
Maine
Maryland
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Mississippi
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Nebraska
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New Hampshire
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New York
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Ohio
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Private Email Address
*
Private Mobile #
*
OPTIMA Data Collection
Main Business Category
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Products
Services
Brands
Specialities
Year Established
Slogan
Payments You Accept
*
Visa
Visa
MasterCard
Amex
Discover
PayPal
Personal Checks
Debit Cards
Cash
Apple Pay
Android 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
Google
Yelp
Bing
Apple Maps
Facebook
Manta
Hot Frog
Yahoo!
Angie's List
TripAdvisor
MapQuest
YP
Merchant Circle
Foursquare
Zomato
City Squares
Chamber of Commerce.com
OPTIMA Program Amount
*
+Social Program Amount
*
Posting Program Amount
*
Total Sale Amount
*
POS Amount
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
What to use for 1st Post Idea?
*
Business Description
Create Post
1st Post Idea to Create
*
Call to Action Button
*
Call Now
Send Email
Learn More
Additional Notes
Appointment Time for Social Specialist to Call
*
Best Contact Name and Phone #
*
Sales Rep Name
*
Website
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