Billing Info

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Local Pack Marketing Billing Info

This form is for your local pack marketing billing info.
Need help? Give us a call – 616.953.6195

Business Name*
Billing Contact Name*
First Name Last Name
Authorized Billing Email Address*
Billing Contact Phone*
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Payment Info*
This will be used for third party services like Google Ads, CallRail, Facebook Ads etc. We will not set anything up unless we've agreed to do so.
- I Agree to all Madroit Marketing to set up accounts on behalf with my payment info.
- I will not provide payment info and I will set up all of my third party accounts.
Self destructing message?
- Would you rather send in a self destructing message?
Use https://1ty.me/ to create a self destructing message. It self destructs after being opened.

Please include all of the following needed information:
- Name on Card:
- Card Number:
- Expiration Date:
- Zip Code for the card:
Your Self Destructing Link:
Please confirm the needed information is in the message.
Name On Credit or Debit Card:
First Name Last Name
Card Number:*
Expiration Date:
Month:
Year
Security Code*
Do you authorize Madroit Marketing to Install CallRail call tracking?
This is recommended. CallRail is a service you will own. It allows marketers track the users calling your company and attribute those calls to the proper marketing channels. You will own and have complete control over this, we will just use this as reporting.

Watch this short video on CallRail: https://www.youtube.com/watch?v=S4sViP_aRjo
- Yes
- No
The CallRail license and its telephone numbers will be the property of your company. CallRail costs will vary based on your usage. We will be offering a courtesy discount of $45/mo to help cover some of those fees. Watch this video for more information: https://www.youtube.com/watch?v=S4sViP_aRjo
Additional Requests/Instructions?
Marketing Point of Contact (POC) Email*
IMPORTANT: The person's email you entered above will receive crucial next steps needed to successfully launch your campaign.

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