Instructions

Please fill out this form to the best of your ability. A Directory MDrepresentative will contact you shortly.

Email: Info@MyDirectoryMD.com
Main: (877) 874-1480

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Get your business live and optimized in the directory in less than 48 hours! Submit your application and we will start on it ASAP. A Directory MD representative will contact you during regular business hours for final set up.

Note: The 48 hour activation is only available for businesses that are able to receive phone verifications. Google requires validation of businesses via phone or mail. Most companies can be verified by phone unless they use a PBX or ACD phone system that requires extensions. If you have a phone system that does not ring straight through, you will be required to verify your business by mail and may take up to two weeks to receive the verification code from Google.Directory MD has no control of the mail verification and therefore cannot promise a specific due date.

 

Directory Order Form:

 

Contact Name :

Business Name:

Business Street Address:

Business State:

Business City:

Business Zip Code:

Email:

Phone:

Alternate Phone:

Fax:

Website Address :

Keyword 1 : IE Plumbing Service

Keyword 2:

Keyword 3:

Keyword 4:


Keyword 5:

Hours of Operation:

Payments you accept: (IE Cash, Visa, Checks, etc.)

Description of Business:

Coupon Information: (only fill out if you wish to provide a coupon)

Headline: (IE "1/2 of all shirts")

Sub Heading: (IE "Wide selection of clothing")

Terms: (IE "present at counter, one per customer")

Offer Code: (Optional if you wish to have a code number)