Client Intake Form | PMC Media Group

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Client Intake Form

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Contact Name (first and last): *

First

Last

Title *

Email *

Phone Number *

Company Name *

Company Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you the company owner? *

Yes
No

Do you have authority to make decisions on your company’s behalf? *

Yes
No

Company social media handles, please list all: *

What industry is your company in: *

What audience does your company serve? Select all that apply: *

Public/Consumers (B2C)
Businesses (B2B)
Other

If other, please explain: *

Tell us about your company! What is your company mission? *

What is your company’s edge over competitors? What do you do better? Different? *

What is your preferred method of communication: *

Email
Phone
Text

Please share mobile number: *

Are you the main point of contact?

Yes
No

Contact Name *

First

Last

Email Address *

Phone Number *

Title: *

What marketing services would you like more information on? Select all that apply: *

Branding
Company or Product Name Development
Logo Design
Creative Design Services
Website Development
Website Management
Ecommerce
Search Engine Optimization
Video Production
TV Commercial
Photography
Drone Production
Media Placement and Buying
Advertising
Press Releases
Social Media
Social Media Paid Advertising
Search Engine Marketing
Digital Marketing
Geofencing

Please describe your project(s) *

What is your project goal? *

What is your biggest obstacle in achieving your project goal? *

Project start date *

Project end date *

Project budget *

On a monthly basis, how much are you looking to invest in new marketing ideas? *

How do you plan to gauge/track the effectiveness of an advertising campaign? *

Describe your target audience and geographic markets. *

Describe your current marketing program. How does your company generate new business? *

What type of marketing and advertising are you doing or have you done in the past?

Newspaper
Magazine
TV
Radio Outdoor/Billboard
SEO
Paid Search
Managed Social Media
Paid Social Media
Digital Banners/Display Ads
E-mail Marketing
Other

What states, cities or geographic regions does your project impact or need to reach? *

Which companies in your industry do you admire? *

Which companies in your industry are your competitors? *

Are you currently working with a marketing agency or have services under contract? *

Yes
No

Please explain *

How did you hear about us? *

Epic
Extraordinary
Impactful

Partner With Us

RI

East Greenwich,

Rhode Island

Northeast

694 Main St. East Greenwich, RI

FL

West Palm Beach,

Florida

East Coast

515 N Flagler Drive Suite 350, West Palm Beach, FL

NY

New York,

New York

PMC Metro

14 Wall St, 20th Floor, New York City, NY

TX

Dallas,

Texas

South Central

3232 McKinney Ave, Dallas, TX

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(800) 852-9558

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Please enable JavaScript in your browser to complete this form.

Name *

First

Last

Email *

Phone *

Company / Brand Name *

Let Us Know How We Can Help! *

Expertise
- Digital Marketing

Expertise
- Digital Marketing

Digital Marketing

Ignite Your Brand

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