Business Profile Intake Form

Please fill out all of the fields below as completely as possible. The more complete your entries, the better we’ll be able to do our work and get your business ranked highly for local searches. If you have any questions, please contact us at info@yoleesolutions.com

Basic Business Info

Business Name(Required)

Parent Company/Corporate Name

Primary Contact Name*(Required)

First Last

Primary Contact Email(Required)

Main Company E-mail(Required)

Main Local Phone(Required)

Alternate Phone

Toll-free Phone

Fax Number

Your Mobile Phone

Should Your Mobile Number be Visible on Public Listings?

Yes

Business Address (PHYSICAL address only, no PO Boxes)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Tag Line/Motto

Business Description(Required)

The Story of Your Business

Products Carried

Brands Carried

Services Offered

Specialties

Professional Associations and Memberships

List of Cities/Geographical Area(s) Serviced

Number of Locations

Number of Employees

Year Founded

Website and Social Media Info

Company Website

Link to Coupon/Incentive Offer

Description of Special offer, Discount or Coupon

Links to Photos

Links to Videos

Social Networking & Review Sites

Please provide your links below

Bing Local

Yahoo! Local

Facebook (Fan Page)

Twitter

Youtube

Yelp

Foursquare

Super Pages

City Search

Insider Pages

Kudzu

Angel's List

Judy's Book

Merchant Circle

Yellow Pages (YP.com)

Others

Other Directory, Review or Social Network Links

Links to Positive Reviews

List of Search items You Would Use to Search for Your Products and Services on the Search Engines(Required)

Business Industry Main Categories / NAICS Codes (select all that apply)*(Required)

Agriculture, Forestry, Fishing and Hunting

Mining, Quarrying, and Oil and Gas Extraction

Utilities

Construction

Manufacturing

Wholesale Trade

Retail Trade

Transportation and Warehousing

Postal Service

Information

Finance and Insurance

Real Estate and Rental and Leasing

Professional, Scientific and Techincal Services

Management of Companies and Enterprises

Administrative, Support, Waste Management, Remediation Services

Educational Services

Health Care and Social Assistance

Arts, Entertainment, and Recreation

Accommodation and Food Services

Other Services (except Public Administration)

Public Administration

Other

Business Industry Main Categories (select all that apply)(Required)

Please select all categories that describe your business in here - Google Business Profile Categories (2024 List)

Customer Sectors Serviced

Residential

Commercial

Industrial

Government

Business Structure(Required)

Sole Proprietorship

Partnership

General Partnership

Limited Partnership

"C" Corporation

"S" Corporation

Professional Corporation

LLC

LLP

Trust

Non-Profit Organization

Other

Payment Types Accepted (select all that apply)

Cash

Check

AmEx

VISA

MasterCard

Discover

Diner's Club

Debit Card

Traveler's

Check

Store Card

Day/Hours of Operation

Enter the days and hours your business is open in the box below. Be sure to explicitly specify all days you are closed for business.

Please provide your working hours from Monday-Sunday

Multiple/Split Hours of Operation

Check here ONLY if you run a split schedule (2 sets of working hours per day)

Upload Company Logo and Photos

Pictures are critical to successful, highly ranked listings. Please upload to us a .ZIP archive file containing your company logo artwork as well at least 5 and preferably 10 photos related to your company (building exterior/interior, job photos, employees, products you make, etc.) Photos should be in JPG or PNG format where possible, and please be sure that you own the copyright or a license permitting you to use all photos provided. Our company will not be responsible for copyright infringement issues related to materials provided by you for use in your listings.

File

Drop files here or

Accepted file types: jpg, jpeg, png, Max. file size: 128 MB.

Authorization and Verification

Authorization and Release to Perform Work(Required)

I understand and acknowledge the above, and authorize your company's agents to represent our company in performing the work described herein.

I hereby state that I am an authorized representative of the above business, and authorize MoLo Media to use of all our business' logos, trademarks, Web site images, etc., for use in creating directory listings, informational pages, and any other uses as deemed necessary by MoLo Media for search engine positioning and optimization.

Your Name(Required)

First Last

Your Title(Required)

Consent(Required)

All cancellations require a 30 Day Notification and all subscription payments within those 30 Days will be collected.

Name

This field is for validation purposes and should be left unchanged.