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Digital Ad Intake Form
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Client Information
Company Name
Client Name
*
First
Last
Email
*
Phone
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Project Information
Project Title
Company Website / URL
Project Description
Describe the products and services your company is offering?
Can you name some of your company competitors?
What are your company goals?
How much is the company Monthly Advertisement/Digital Marketing budget?
$500 - $5000
$5000 - $10,000
$10,000 - $15,000
$15,000 - $20,000
$25,000+
Do you have an eCommerce store?
How far are you right now from achieving the company goal?
Campaign - Information
Where will this campaign set be ran?
Facebook
Google
LinkedIn
Twitter
TikTok
Microsoft
Pinterest
Snapchat
Yelp
Programmatic Advertising
Campaign Running Dates
Do you have webcopy for your campaign? If so please supply it below
Ad Content - (Creatives)
Click or drag a file to this area to upload.
Ad's Creative & Media Dropbox Location - (If Applicable)
How long will this campaign be running?
Please specify how many Days/Months you will be running the campaign.
Special Instructions or Details?
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