Name
Company Name
Contact Number:
Email
Do you have a website domain that is currently being hosted?
Please Select
Yes
No
If yes, please supply contact details of your hosting service provider (the company you pay each month to host your website or email)
Would you like us to host your landing page?
Please Select
Yes
No
What is the main purpose of the landing page?
Please Select
Generate leads
build a database
Download a brochure
Take up an offer
Is there something we can offer to encourage them to take the action you want, eg. Free consultation, special price, etc. Please be specific about exactly what they will get if they fill out the form on the landing page.
What are you selling?
What problem are you trying to solve?
Are you offering anything unique that your competitors aren’t, and you know is important to your customer?
How does your product or service help people?
We want them to give us their details by filling out the form. Can you tell us what you think would encourage them to do so, eg. Free consultation; Free demo; 20% off; download something that will help them (not your brochure).
Please provide as much relevant information about the products/services that you are promoting. If you have a separate document, brochure or a web page with the content, please provide that.
What makes you different from your competitors?
Do you have any examples of your work or photos of your product that we can include? Please send them to us.
Please Select
Yes, I will email them through!
No
What can people expect if they choose your product or service?
Do you have any client testimonials or reviews on FB and Google that we can include? Please send them to us.
Please Select
Yes, I will email them through!
No
Are there any special accreditations/certifications that we need to include? Please send us the relevant logos.
Please Select
Yes, I will email them through!
No
What telephone number can we include on the landing page?
What email address should we send your leads to?
Do you have a MailChimp account?
Please Select
Yes
No
Would you like us to link the landing page to your MailChimp account?
Please Select
Yes
No
Do you have a video you would like us to include?
Please Select
Yes
No
Do you have photos or images that we can use?
Please Select
Yes, I will email them through
No
SUBMIT
