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Interested in working 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 as thorough as possible with the details that you provide – the more you give us to work with, the more we can do for you and your business.

General Information

Your Name (required):

Your Email (required):

Your Personal Phone Number:

Which Services Are You Interested In? (Check all that apply)
Pay-Per-Click (PPC)Search Engine Optimization (SEO)Social Media MarketingWebsite DesignGraphic DesignBrandingVideo ProductionEmail MarketingNot Sure?

Business Information

Your Business Name:

Business Phone Number/s:

Business Physical Address:

Business Email:

*Ask us about setting up a custom email address for your business:

Business Website Address:

Hours of Operation:

Payment Types Accepted:
CashCheckVisaMasterCardDiscoverAmerican ExpressBitcoinPayPalGoogle CheckoutVenmoInsuranceFinancing

What Year Did Your Business Start?

Business Description:

Owner Bio:

Products/Services Offered:

Specials or Promotions:

Location Targeting

Please list your target cities in order of importance:

Existing Accounts

Do you have existing accounts with sites such as Google+, Facebook, Twitter, Angie's List, Yelp, Manta,, Google Analytics, Google AdWords or any others? If so, please provide the login information below so we can manage those accounts.

PPC Account Information

You can disregard this section if you are not signing up for the PPC service

AdWords/Bing Ads Account Login Information

Ad Budget

Ad Text


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