Local Review Engine Intake
Please complete as many fields as possible. The more complete the better. If a field had an *asterisk and you cannot complete it, just type in the word "later" and we will follow up with you. Thank you.
Organization
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Brand Name - if any
Full Name
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First Name
Last Name
Your Review Engine URL
Example : www.YourName.LocalReviews.com or www.YourBrand.LocalReviews.com TIP : Best to use the name your prospective clients and referral partners will be searching for which in most cases is your name.
Preferred URL Name
*
example : YourName
Alternative URL Name if above is not available.
*
Contact Information
Main Website
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Office Number
*
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Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Best number to reach you
*
Please Select
Office
Mobile
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Next
Notification
Whenever there is any activity on your review engine, you will be notified via email. You can also designate an alternative email other than your primary and add an Assistant as well. NOTE: We do also monitor the reviews on your behalf as well.
Primary E-mail
*
Notification E-mail if different from above
Assistant E-mail
SEO - Search Engine Optimization Keywords
Main Keyword (phrase)
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Secondary Keyword (phrase)
*
About You
*
Generally the same content you have on your main website.
Social Media Properties
First, we want to let you know we respect your privacy and do not share your login credentials with any other entity outside of our own.Access is requested so we can set up the automated posting of your raving fan reviews to all your social sites. In addition the respective links will be added to your review engine home page.
Facebook Fan Page url
Twitter url
LinkedIn Profile url
Username/Email
Google + url
Username/Email
YouTube Channel url
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Next
Your Reputation Management Options
Immediately Publish Reviews By selecting this option, a "Certified Authentic Reviews" banner will appear on your review engine. (NOTE: This only appears if you have your "Threshold" below set to "1 Star", thus displaying full transparency.) Moderate All Reviews Reviews will be Pending Moderation and will NOT be published until approved.
Review Publishing Options
*
Please Select
Immediately Publish Reviews
Moderate All Reviews
Positive Review Threshold : Choose what star level reviews you want to show up on your review engine. If you choose 2 stars, then any reviews 2 stars and under will be hidden.
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External Review Sites
This strictly optional. If you do add Google+ Local and/or Yelp we ask your reviewer to leave a review there ONLY if they are ACTIVE users of those platforms.
Google + Local
Preferred "leave a review" url
Yelp
Preferred "leave a review" url
Other Review Site 1
Preferred "leave a review" url
Other Review Site 2
Preferred "leave a review" url
Google Analytics Tracking Code
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Files - Images
Main Header is 1000px by 160px : Mobile Header is 460px by 150px Test
Do you want us to create your header and mobile banners?
Please Select
Yes - I understand I get up to 1 revision for FREE
No - I will provide my own
Your Profile Photo
Upload a File
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Your Logo
Upload a File
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Other
Upload a File
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Background Image (If none, we'll choose a background color)
Minimum Background Image is 1920px by 575px
Optional Background Image
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You are done :-) Thank you!
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