digitalagencyteam.com
Open in
urlscan Pro
2606:4700:3033::6815:48eb
Public Scan
Submitted URL: https://clientsubmissionform.com/
Effective URL: https://digitalagencyteam.com/digital-services-intake-form/
Submission: On July 21 via automatic, source certstream-suspicious — Scanned from NL
Effective URL: https://digitalagencyteam.com/digital-services-intake-form/
Submission: On July 21 via automatic, source certstream-suspicious — Scanned from NL
Form analysis 1 forms found in the DOM
<form lang="en" tabindex="-1" class="😉 cog-cognito cog-form cog-9 is-default cog-cognito--styled cog-form--light-background cog-cognito--protect-css"
data-width="900 800 700 650 625 600 575 550 525 500 475 450 425 400 375 350 325 300 275 250 225 200">
<div class="cog-form__container">
<div class="cog-form__content"><!---->
<div class="cog-body"><!---->
<div class="cog-page cog-wrapper cog-transition-ltr">
<div class="cog-row"></div>
<div class="cog-row">
<section aria-labelledby="cog-0" tabindex="-1" class="cog-section cog-col cog-col--24 cog-field--5">
<div class="cog-section__inner cog-section__inner--no-background "><!----> <!---->
<div class="cog-row">
<div class="cog-field cog-field--1 cog-col cog-col--12 cog-date cog-date--date"><label id="cog-1-label" for="cog-1" class="cog-label"> Today's Date<!----> <!----> <!----></label>
<div class="cog-picker cog-input">
<div class="el-date-editor el-input el-input--prefix el-input--suffix el-date-editor--date"><!----><input type="text" autocomplete="off" name="" id="cog-1" class="el-input__inner"><span
class="el-input__prefix"><i class="el-input__icon el-icon-date"></i><!----></span><span class="el-input__suffix"><span class="el-input__suffix-inner"><span><svg viewBox="0 0 18 18" focusable="false"
class="cog-icon cog-i-calendar">
<defs></defs>
<g>
<path d="M2.5 3.5h13v12h-13z"></path>
<path d="M4.02 7.5h9.88" class="cog-i-calendar__rule"></path>
<path d="M5.5 5V1.5M12.5 5V1.5"></path>
</g>
</svg></span><!----><!----><!----><!----></span><!----></span><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--7 cog-col cog-col--12 cog-choice cog-choice--dropdown is-required"><label id="cog-2-label" for="cog-2" class="cog-label"> Account Manager<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-choice">
<div class="cog-picker cog-select cog-input">
<div class="el-select el-select--dropdown-bottom"><!---->
<div class="el-input el-input--suffix"><!----><input type="text" readonly="readonly" autocomplete="prevent" id="cog-2" aria-controls="cog-2-listbox" role="combobox" aria-haspopup="listbox" aria-owns="cog-2-listbox"
aria-expanded="false" class="el-input__inner" aria-activedescendant="cog-2-option-null" style="height: 34.8906px;"><!----><span class="el-input__suffix"><span class="el-input__suffix-inner"><span><svg viewBox="0 0 18 18"
focusable="false" class="cog-icon cog-i-chevron">
<g>
<path stroke-linecap="square" d="M3 7l6 6 6-6"></path>
</g>
</svg></span><i class="el-select__caret el-input__icon el-icon-arrow-up" style="display: none;"></i><!----><!----><!----><!----><!----></span><!----></span><!----><!----></div>
<div class="el-select-dropdown el-popper cog-cognito cog-9 cog-cognito--styled cog-select-popper cog-cognito--protect-css " style="display: none; min-width: 462.5px;">
<div class="el-scrollbar" style="">
<div class="el-select-dropdown__wrap el-scrollbar__wrap el-scrollbar__wrap--hidden-default">
<ul id="cog-2-listbox" role="listbox" class="el-scrollbar__view el-select-dropdown__list"><!---->
<li role="option" id="cog-2-option-null" aria-selected="true" class="el-select-dropdown__item cog-select-option--empty selected hover"> </li>
<li role="option" id="cog-2-option-Lauren Conn" aria-selected="false" class="el-select-dropdown__item" style="order: 0;">
<div class=""><!----> <!----> <span>Lauren Conn</span></div>
</li>
<li role="option" id="cog-2-option-Ryan Carpenter" aria-selected="false" class="el-select-dropdown__item" style="order: 1;">
<div class=""><!----> <!----> <span>Ryan Carpenter</span></div>
</li>
<li role="option" id="cog-2-option-Daniel Petraglia" aria-selected="false" class="el-select-dropdown__item" style="order: 2;">
<div class=""><!----> <!----> <span>Daniel Petraglia</span></div>
</li>
<li role="option" id="cog-2-option-Peggy Olson" aria-selected="false" class="el-select-dropdown__item" style="order: 3;">
<div class=""><!----> <!----> <span>Peggy Olson</span></div>
</li>
<li role="option" id="cog-2-option-Unknown" aria-selected="false" class="el-select-dropdown__item" style="order: 4;">
<div class=""><!----> <!----> <span>Unknown</span></div>
</li>
</ul>
</div><!----><!---->
</div><!---->
</div>
</div>
</div>
<div class="cog-choice__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--28 cog-col cog-col--24 cog-choice cog-choice--checkboxes">
<legend class="cog-label"> Select all services in your package<!----> <!----> <!----></legend>
<div class="cog-choice">
<div class="cog-checkable cog-input cog-inner-col cog-inner-col--css-columns cog-inner-col--2">
<div aria-label="checkbox-group" class="el-checkbox-group"><label class="el-checkbox cog-checkable__item cog-inner-col__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox"
class="el-checkbox__original" value="Off Page SEO/Business Listing Optimization"></span><span class="el-checkbox__label">
<div class=""><!----> Off Page SEO/Business Listing Optimization </div><!---->
</span></label><label class="el-checkbox cog-checkable__item cog-inner-col__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original"
value="Google Posts"></span><span class="el-checkbox__label">
<div class=""><!----> Google Posts </div><!---->
</span></label><label class="el-checkbox cog-checkable__item cog-inner-col__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original"
value="Social Media Management"></span><span class="el-checkbox__label">
<div class=""><!----> Social Media Management </div><!---->
</span></label><label class="el-checkbox cog-checkable__item cog-inner-col__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original"
value="Website"></span><span class="el-checkbox__label">
<div class=""><!----> Website </div><!---->
</span></label><label class="el-checkbox cog-checkable__item cog-inner-col__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original"
value="Video Production"></span><span class="el-checkbox__label">
<div class=""><!----> Video Production </div><!---->
</span></label><label class="el-checkbox cog-checkable__item cog-inner-col__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original"
value="Landing Page"></span><span class="el-checkbox__label">
<div class=""><!----> Landing Page </div><!---->
</span></label> <!----></div>
</div>
<div class="cog-choice__placeholder cog-inner-col cog-inner-col--css-columns cog-inner-col--2">
<div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Off Page SEO/Business Listing Optimization</span></div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Google Posts</span></div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Social Media Management</span></div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Website</span></div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Video Production</span></div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Landing Page</span></div> <!---->
</div>
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
</div>
<div class="cog-row"></div>
<div class="cog-row"></div>
<div class="cog-row"></div>
<div class="cog-row"></div>
</div> <!---->
</section>
</div>
<div class="cog-row">
<section aria-labelledby="cog-4" tabindex="-1" class="cog-section cog-col cog-col--24 cog-section--heading cog-field--8">
<div class="cog-section__inner cog-section__inner--no-background ">
<h2 id="cog-4" class="cog-section__heading cog-heading"> Contact Info <!----></h2> <!---->
<div class="cog-row">
<fieldset class="cog-field cog-field--1 cog-col cog-col--16 cog-name is-required">
<legend class="cog-label"> Sales Rep<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-name">
<div class="cog-row"><!---->
<div class="cog-input cog-name__first cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="given-name" id="cog-input-auto-0" placeholder="First" title="First" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!----> <!---->
<div class="cog-input cog-name__last cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="family-name" id="cog-input-auto-1" placeholder="Last" title="Last" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!---->
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
<div class="cog-field cog-field--35 cog-col cog-col--8 cog-email"><label id="cog-6-label" for="cog-6" class="cog-label"> Sales Rep Email<!----> <!----> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="email" id="cog-6" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--3 cog-col cog-col--16 cog-name is-required">
<legend class="cog-label"> Submitted By:<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-name">
<div class="cog-row"><!---->
<div class="cog-input cog-name__first cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="given-name" id="cog-input-auto-2" placeholder="First" title="First" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!----> <!---->
<div class="cog-input cog-name__last cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="family-name" id="cog-input-auto-3" placeholder="Last" title="Last" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!---->
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
<div class="cog-field cog-field--4 cog-col cog-col--8 cog-email is-required"><label id="cog-8-label" for="cog-8" class="cog-label"> Submitted By Email<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="email" id="cog-8" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--6 cog-col cog-col--16 cog-name is-required">
<legend class="cog-label"> Client Contact Name<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-name">
<div class="cog-row"><!---->
<div class="cog-input cog-name__first cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="given-name" id="cog-input-auto-4" placeholder="First" title="First" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!----> <!---->
<div class="cog-input cog-name__last cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="family-name" id="cog-input-auto-5" placeholder="Last" title="Last" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!---->
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
<div class="cog-field cog-field--7 cog-col cog-col--8 cog-email is-required"><label id="cog-10-label" for="cog-10" class="cog-label"> Client Email<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="email" id="cog-10" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--36 cog-col cog-col--12 cog-choice cog-choice--radiobuttons is-required">
<legend class="cog-label"> Contact Preference<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-choice">
<div class="cog-checkable cog-input cog-inner-col cog-inner-col--css-columns cog-inner-col--1">
<div class="el-radio-group"><label role="radio" aria-checked="false" tabindex="0" class="el-radio cog-checkable__item cog-inner-col__item"><span class="el-radio__input"><span class="el-radio__inner"></span><input type="radio"
aria-hidden="true" tabindex="-1" class="el-radio__original" value="Sales Rep"></span><span class="el-radio__label">
<div class=""><!----> Sales Rep </div><!---->
</span></label><label role="radio" aria-checked="false" tabindex="-1" class="el-radio cog-checkable__item cog-inner-col__item"><span class="el-radio__input"><span class="el-radio__inner"></span><input type="radio"
aria-hidden="true" tabindex="-1" class="el-radio__original" value="Client"></span><span class="el-radio__label">
<div class=""><!----> Client </div><!---->
</span></label><label role="radio" aria-checked="false" tabindex="-1" class="el-radio cog-checkable__item cog-inner-col__item"><span class="el-radio__input"><span class="el-radio__inner"></span><input type="radio"
aria-hidden="true" tabindex="-1" class="el-radio__original" value="Sales Rep + Client"></span><span class="el-radio__label">
<div class=""><!----> Sales Rep + Client </div><!---->
</span></label> <!----></div>
</div>
<div class="cog-choice__placeholder cog-inner-col cog-inner-col--css-columns cog-inner-col--1">
<div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Sales Rep</span></div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Client</span></div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>Sales Rep + Client</span></div> <!---->
</div>
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
</div>
</div> <!---->
</section>
</div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----></div>
<div class="cog-row">
<section aria-labelledby="cog-12" tabindex="-1" class="cog-section cog-col cog-col--24 cog-field--23">
<div class="cog-section__inner cog-section__inner--no-background "><!----> <!---->
<div class="cog-row">
<fieldset class="cog-field cog-field--10 cog-col cog-col--12 cog-choice cog-choice--radiobuttons is-required">
<legend class="cog-label"> Do you need a kick-off call?<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-choice">
<div class="cog-checkable cog-input cog-checkable--inline">
<div class="el-radio-group"><label role="radio" aria-checked="false" tabindex="0" class="el-radio cog-checkable__item"><span class="el-radio__input"><span class="el-radio__inner"></span><input type="radio" aria-hidden="true"
tabindex="-1" class="el-radio__original" value="Yes"></span><span class="el-radio__label">
<div class=""><!----> Yes </div><!---->
</span></label><label role="radio" aria-checked="false" tabindex="-1" class="el-radio cog-checkable__item"><span class="el-radio__input"><span class="el-radio__inner"></span><input type="radio" aria-hidden="true"
tabindex="-1" class="el-radio__original" value="No"></span><span class="el-radio__label">
<div class=""><!----> No </div><!---->
</span></label> <!----></div>
</div>
<div class="cog-choice__placeholder">
<div>
<div class="cog-choice__checkable-placeholder"><span>Yes</span></div>
<div class="cog-choice__checkable-placeholder"><span>No</span></div> <!---->
</div>
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
</div>
<div class="cog-row"><!----></div>
<div class="cog-row"><!----><!----></div>
<div class="cog-row"><!----><!----></div>
<div class="cog-row"><!----><!----></div>
</div> <!---->
</section>
</div>
<div class="cog-row">
<div class="cog-col cog-col--24">
<div class="cog-content cog-html cog-input">
<p><strong>IMPORTANT NOTE: Saving this form will give you a form link. Please save the link to finish later, and then submit form when it's complete.</strong></p>
</div>
</div>
</div>
<div class="cog-row" style="display: none;">
<div class="cog-field cog-col cog-col--12"><!----></div>
</div>
<div class="cog-page__navigation"><!----> <button type="submit" class="el-button cog-button--has-status cog-button--primary cog-button--navigation cog-button--submit el-button--default cog-button" data-next=""
data-action-name="Submit"><!----><!----><span><!----> <span class="cog-button__text"> Submit </span> <!----> </span></button> <button type="button"
class="el-button cog-button--has-status cog-button--save cog-button--secondary cog-button--navigation el-button--default cog-button"><!----><!----><span><!----> <span class="cog-button__text"> Save</span> <!----> </span></button></div>
<!---->
</div>
</div>
<div tabindex="0" class="cog-dialog cog-save-resume-dialog" embedded="true" emailmessage="">
<div class="el-dialog__wrapper" style="display: none;">
<div role="dialog" aria-modal="true" aria-label="dialog" class="el-dialog" style="margin-top: 15vh;">
<div class="el-dialog__header"><span class="el-dialog__title"></span><button type="button" aria-label="Close" class="el-dialog__headerbtn" title="Close"><i class="el-dialog__close el-icon el-icon-close"></i><svg viewBox="0 0 18 18"
focusable="false" class="cog-icon cog-i-ex">
<defs></defs>
<g>
<path d="M4.2 4.2l9.6 9.6M13.8 4.2l-9.6 9.6"></path>
</g>
</svg></button></div><!----><!---->
</div>
</div>
</div><!----><!---->
</div>
</div>
</form>Text Content
Skip to content * Home * Digital Services Intake Form * Agency Support Requests * Website Styles Main Menu * Agency Support * Digital Services Intake Form * Email Templates * Home * Portfolio * Website Templates DIGITAL SERVICES INTAKE FORM No matter if you are a Main Street merchant or a large media company, we can help you leverage a variety of digital marketing opportunities to grow your business. Our team, composed of Digital Marketers, Social Media Experts, and Design Pros is laser-focused on delivering a positive, high-quality experience that positions you for success. Please take a few moments to tell us about your business, via our Digital Services Intake Form, so that we can be better prepared for your Digital Services Kick-Off call. Today's Date Account Manager* (required) * * Lauren Conn * Ryan Carpenter * Daniel Petraglia * Peggy Olson * Unknown Select all services in your package Off Page SEO/ Business Listing Optimization Google Posts Social Media Management Website Video Production Landing Page Off Page SEO/Business Listing Optimization Google Posts Social Media Management Website Video Production Landing Page CONTACT INFO Sales Rep* (required) Sales Rep Email Submitted By:* (required) Submitted By Email* (required) Client Contact Name* (required) Client Email* (required) Contact Preference* (required) Sales Rep Client Sales Rep + Client Sales Rep Client Sales Rep + Client Do you need a kick-off call?* (required) Yes No Yes No IMPORTANT NOTE: Saving this form will give you a form link. Please save the link to finish later, and then submit form when it's complete. Submit Save Copyright © 2024 digital agency team Scroll to Top