Local Citation Builders Citation Intake Form
Please fill out all the requested information. The first section is for you, the second section is for your citations.
Email address *
Section 1
Purchaser Information (You)
Your Name *
First & Last
Your answer
Citation Package Ordered *
# of citations ordered
Your answer
Section 2 - ORDER DETAILS
Make sure all fields are filled out CORRECTLY! This is what will be used in your citations.
Business Name *
Your answer
Business Street Address *
This is the EXACT street address that will be used and shown for all listings and directories
Your answer
Business City *
Your answer
Business State *
Full state or 2-letter abbreviations are acceptable
Your answer
Business Zip Code *
Your answer
Business Phone Number *
Full phone number, area code first
Your answer
Business Email Address *
The email address you want displayed on your citations ex: myname@example.com
Your answer
Business Owner Name *
First name & Last name
Your answer
Business Website Url *
Your answer
Business Hours of Operation
Your answer
Short Business Description *
Your answer
Business Categories *
ex: dentist, roofer, landscaping, etc
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms