(813) 699 0411
(321) 445 6059
5100 N Florida Ave,
Tampa,FL 33603
info@businesslocallistings.com
Local Search Management Order Form


   Please fill out the form below for your order

   Sales Agent
   Listing Information (Customer Information)
Company Name
 Company Address
First Name
 Last Name
Phone Number
 Fax Number
Email
 Website Address
Business Description
   Search Phrases (Please enter your search phrases below related to your business.)

   Operating Hours (Make sure your customers know when you’re open.)
  I prefer not to specify operating hours
  My operating hours are:

Mon:  - Closed
Tue:  - Closed
Wed:  - Closed
Thu:  - Closed
Fri:  - Closed

   Payment Options (Specify how customers can pay at your business.)
Cash American Express Visa
Check Diner's Club Financing
Traveller's Check Discover Google Checkout
Invoice Mastercard Paypal

   Packages
( Includes 1st month of service )
3 Phrases = $149/month ($299 set up) : Total $448
6 Phrases = $199/month ($299 set up) : Total $498
10 Phrases = $249/month ($299 set up) : Total $548

   Custom Package
Custom LSM
  Phrases   $ /Month
Custom set-up fee
  $ One time

   Website Package
  No. of pages   $ Price

   Other Fees
  Details   $
  Details   $

   Payment Information (Please enter your credit card details below.)
Payment: ACH VISA MC AMEX
Bank or Card Holder Name:
 Acct # or Card #:
Routing #:
 Expiration Date: mmdd (1019)
 CVV #:
Billing Address:
City:
 State:
 Zip:



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