Client Information Worksheet

I used to have paper worksheets, but decided that I was tired of generating more paper than necessary. So this form is online and I appreciate you taking a moment to complete it so that all of the "details" are covered here. Thanks for your help.

Business/Organization Information
Organization Name*
Address*
Street AddressAddress Line 2CityStateZip Code
Website
Primary Contact Information
Name*
PrefixFirstLastSuffix
Title or Position
Email*
Main Phone*
Mobile Phone
Billing Information
All billing is done online through email. Payment can be done online with a major credit card using Google Checkout, or simply by sending a check. Please let me know if you need the W9 for HowardYermish.com LLC or a copy of the NJ Business License.
Billing Contact Option*
- Use the primary contact information above for the billing contact.
- Please send all billing correspondance to the contact below.
Name
PrefixFirstLastSuffix
Email
Phone
Address
Street AddressAddress Line 2CityStateZip Code
Additional Organization Contacts
If there will be more people working with the project, please provide their information below.
Name of Contact 1
PrefixFirstLastSuffix
Title of Contact 1
Email of Contact 1
Phone of Contact 1
Name of Contact 2
PrefixFirstLastSuffix
Title of Contact 2
Email of Contact 2
Phone of Contact 2
Name of Contact 3
PrefixFirstLastSuffix
Title of Contact 3
Email of Contact 3
Phone of Contact 3
Internet Assets
Aside from your website, you may have other Internet assets, such as additional websites, blogs, LinkedIn profiles, Facebook pages, etc.
Blog
Facebook Fan Page
Twitter Profile
LinkedIn Profile
Other Online Assets
Just One More Thing...
If there is anything else that you think we should know about, feel free to enter it in the general comments below.
General Comments

Client Information Worksheet

Business/Organization Information

Primary Contact Information

Billing Information

Additional Organization Contacts

Internet Assets

Just One More Thing...

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