Client Information

Clarence Home can have you up on the web at a very low cost. Please contact us for advertising information.
Download this form in Microsoft Word format here.

Client Information

The information requested below will allow us to launch an informative Internet presence for you.

Please print, fill out, and mail this form to Clarence Home LLC, 5225 Goodrich Road, Clarence, NY 14031 with your user agreement and check or money order. As a preferred option, download the Microsoft Word version here and email the completed version back to Sales@ClarenceHome.com, with your business name in the subject heading.

Plan Desired: Standard ____ Gold ____

Company Name: ______________________________________________

Nature of business: ______________________________________________

Contact Name: ______________________________________________

Contact Title: ______________________________________________

Address: ______________________________________________

______________________________________________

City, State, ZIP: ______________________________________________

Email address: ______________________________________________

Tel Number: ________________________________________________

Cell Number: ______________________________________________

Fax Number: ______________________________________________

Best time to call: ______________________________________________

In business since: ______________________________________________

What is your main purpose for advertising on Clarence Home?

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Directions to your location(s). Include any landmarks that may help a first time visitor.

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What do you wish to call your home web address (yoursite), using the format http://www.ClarenceHome.com/yoursite? It is suggested that this be kept short but descriptive (i.e. http://www.ClarenceHome/TownHall).

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If you have an email address you wish listed at Clarence Home please note it here (call Juno at 1 (800) TRY-JUNO or visit them on the web at http://www.juno.com if you would like free email):

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If you have web sites you would like listed at Clarence Home note them here (up to 5):

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Gold Plan Only: If you have any images you wish to include on your site please note them here and include in mailing or email (as attachment):

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What is your preferred heading (i.e. Auto Repair, Restaurants, Video Rental, etc.)?

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Please describe your business in a form that would attract clientele. Include services and or products your organization provides, and any unique characteristics. Use several descriptive sentences. This will be included on your home page:

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What would make a potential customer choose you over others?

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What "keywords" (up to 10) would you use to describe the uniqueness of your business (i.e. wicker baskets, Lindt chocolate, Barbie dolls, 78-RPM records, etc.)?

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What keywords (up to 5) would you use to describe the common elements of your business (i.e. pizza, take-out, restaurant)?

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What are your hours of operation?

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What type of customer are you looking for?

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Gold Plan Only: If you are a restaurant, would you like your menu listed? ____ YES ____NO

If you do, can you mail (diskette) or email (file) if available? ____ YES ____NO

If not, send a version that can be scanned:

Version for scanning to be sent: ____ YES ____NO

Gold Plan Only: If you have any special items to be scanned, please note here and mail with instructions.

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What do you like about Clarence and your customers (optional)?

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Favorite web site (optional):

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Do you have products you wish to sell over the Internet? ____ YES ____NO

Would you be interested in setting up the capability to sell via the Internet? ____ YES ____NO

If you have special requests or instructions, please attach a separate sheet.

A draft version of your web site will be created soon after Clarence Home LLC receives this form along with your check or money order. Your web site will then be mailed (conventional or email) to you for your review, correction, and approval. Once it is returned to us, it will be updated and uploaded to ClarenceHome.com for the world to view!

For those who are not quite ready to advertise with Clarence Home LLC, you can still have your name, address, phone number and fax number listed for free in the ClarenceHome.com directory. All you have to do is agree to post the www.ClarenceHome.com decal on your main entrance door. If you could, please note your reason for not joining us:

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I am not interested in advertising with Clarence Home LLC now, but I would like to take advantage of your free listing offer, and I agree to post the www.ClarenceHome.com label* on my entrance door.

Initial: ______

* A decal will be mailed to you soon after this form is received. The www.ClarenceHome.com label should be placed on the inside of your entry door. Clean the glass surface, peel off the backing (one corner has the backing creased), and place on door at eye level. Thank you!

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