Client Questionnaire - Easy Capture Media

Fill out the form below to

Get Started with ECM

Fill out the information below to the best of your knowledge. Something that you are unsure of the answer? Simply put what you know and we will work together to figure out the rest. Questions? Give us a call at (800) 948-6015.

First Name*

Last Name*

ECM Package*

Company Name*

Address

Email Address*

Website Address*

Where is your website hosted?*

Hosting Login Username*

Hosting Login Password*

Website Login URL* (To access the website backend, like WordPress or other editor access.)

Website Login Username*

Website Login Password*

Do You Have a Youtube Account?*

Please invite analytics@affordableimage.com to be a manager of the channel.
Done

Would You Like Us To Create a YouTube Channel For You?*

Preferred Method of Contact*

Attach high resolution or vector logo file*

(.ai .eps .pdf preferred. Jpg or Png at least 1080x720 acceptable)

Phone Number to use on any video Call to Actions*

Email to use on any video Call to Actions*

Do you have a Business Facebook page?*

Our social media team will send an invite to your page and you will need to accept.
Understood

Do you have a Business Instagram page?*

Instagram Username*

Instagram Password*

Do you have a Business Twitter page?*

Twitter Username*

Twitter Password*

Do you have a Business LinkedIn page?*

Please follow @AI_BusinessPage ManagementProfile and invite this profile to manage the page.
Done