PPC Sign-Up

Interested in Pay-Per-Click services with Kite Media? Fill out the form below to provide us with the information that we need to get started with your business. Please be thorough with the details that you provide.

    General Contact Information

    Please share your contact information for our internal communication. This will not be displayed publicly on your ads.

    Your Name (required):

    Your Email (required):

    Your Personal Phone Number:

    Your Franchise Number (if applicable):

    Business Information

    This is the information that will be displayed publicly on your ads and within your website.

    Your Business Name:

    Business Physical Address:

    Business Phone Number/s:

    Business Email:


    Hours of Operation:

    Ad Scheduling:

    Products/Services To Advertise:


    Location Targeting

    Please list your target cities in order of importance:

    Account Information

    Google Ads Account Login Information

    Google My Business Account

    Ad Budget

    Ad Text


    Anything else you would like us to know?

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