How to save an electronic copy of the AgencyThrive Questionnaire (PDF)

1. Open the AgencyThrive questionnaire in Adobe Reader VI or greater 2. Type directly into the PDF

3. Once you have completed the questionnaire, select the “File” dropdown menu and select “Save As”.

4. You may rename the Questionnaire or save it as is. 5. Select the folder or location where you would like to save the questionnaire. You may

want to save it to your Desktop for quick and easy access.

6. Click “Save” 7. Open your email account and compose your email. Select “Insert File” or “Attach

File”. Locate the saved PDF Questionnaire in the folder you selected to save the Questionnaire or in your Desktop folder and select “Attach” or “Insert File”.

For Internal Use Only Agency: ______________________________ Cust#: ____________ Date Received: ______________

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Agency General Information Agency Name: _____________________________________________________________________________________________

(List the name exactly like you want it to appear on your website, graphics and/or logo.)

Main contact(s) for all AgencyThrive website and/or web marketing correspondence and questions:

Name _________________________ Title __________________ Phone # _________________ Email _______________________

Name _________________________ Title __________________ Phone # _________________ Email _______________________

Physical Address (Multiple Locations - See additional Multiple Location Page) Address as it appears in print and storefront. Is North abbreviated "N." or "N"? Is there a Suite number? Does it appear as "Suite #110" or "Ste. 110".

Address: __________________________________________________________________________________________________

Address2: _________________________________________________________________________________________________

City: _______________________________________________ State: ________________________ Zip: ____________________

Phone Number: ___________________________________ Additional Phone Number: _________________________________

Toll-Free Phone Number: ______________________________________ Fax Number: __________________________________

Contact(s) & Email Address(es) (to be used on your contact page of your website) If more than one, please list additional email addresses in the order you would like them to appear on the contact page.

Name: ___________________________________ Title: ___________________ Email: ___________________________________

Name: ___________________________________ Title: ___________________ Email: ___________________________________

Name: ___________________________________ Title: ___________________ Email: ___________________________________

Hours of Operation – REQUIRED If available by appointment, please note. *Note split hours if closed for lunch.

Additional hours: __________________________________________________________________________________________

Open Close *Open *Close

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Please type directly into this PDF, save a copy to your computer, and email back to us. Only electronic copies will be accepted. Do not handwrite. Do not print and scan.

For Internal Use Only Agency: ______________________________ Cust#: ____________ Date Received: ______________

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Agency General Information (cont.) Date Agency Opened (Month & Year) – REQUIRED: _______________________________________________________________

Forms of Payment (Payment Options) – REQUIRED:

Cash Debit Card

Personal Check Travelers Checks

Visa Money Order

MasterCard Other: ___________________________

American Express Other: ___________________________

Discover Other: ___________________________

Languages Spoken:

English Spanish

Mandarin French

German Russian

Japanese Arabic

Hindi Korean

About Your Business What discounts does your agency offer?

Do you hold any Insurance Certifications and/or Licenses?

Anti-Lock Brake Discounts

Anti-Theft Discounts

Automatic Payment Discount

Defensive Driver Discount

Distant Student Discount

Early Signing Discount

Good Student Discount

Green Vehicle Discount

Military Discount

Multiple Policy Discounts

Multi-Vehicle Discounts

Paid-In-Full Discount

Paperless Discount

Passive Restraint Discount

Chartered Property Casualty Underwriter (CPCU)

Associate in Claims (AIC)

Associate in Insurance Services (AIS)

Associate in Personal Insurance (API)

Accredited Advisor in Insurance (AAI)

Other ______________________

Other ______________________

Other ______________________

For Internal Use Only Agency: ______________________________ Cust#: ____________ Date Received: ______________

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About Your Business (cont.)Please select all lines of business you write. For those not listed, please use the “OTHER” fields below. REQUIRED

Aviation Insurance

ATV Insurance

Boat Insurance

Builder's Risk Insurance

Business Owner's Policy

Business Property & Liability

Catastrophe Insurance

Commercial Auto Insurance

Commercial Liability Umbrella

Commercial Property Insurance

Condo Insurance

Dental Insurance

Disability Insurance

Flood Insurance

General Liability Insurance

Hazard Insurance

Health Insurance

Homeowner's Insurance

Landlord Insurance

Life Insurance

Liquor Liability

Marine Insurance

Medicaid Insurance

Medicare Supplements

Mobile Home Insurance

Motorcycle Insurance

Personal Auto Insurance

Personal Liability

Pet Insurance

Professional Liability Insurance (E&O)

Renter's Insurance

RV Insurance

Special Event Insurance

SR22s

Surety Bonds

Title Insurance

Travel Insurance

Umbrella Policies

Vacant Property Insurance

Watercraft Insurance

Worker's Compensation Insurance

Other ____________________________

Other ____________________________

Other ____________________________

Other ____________________________

Other ____________________________

What lines of business and services do you want to emphasize on your website?

__________________________________________________________________________________________________________

Does your agency have a tagline? Taglines are the first step and an integral part of brand building. Their value builds for years, and over time, a good tagline can be your best and least expensive form of advertising all working together as they should, they become an ad in and of themselves. A tagline creates a first impression. People will remember a tag phrase even before an agency name.

__________________________________________________________________________________________________________

For Internal Use Only Agency: ______________________________ Cust#: ____________ Date Received: ______________

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About Your Business (cont.) About your agency (Agency History and Information) - REQUIRED Who is your intended audience (potential clients and/or current clients)? Have you been in the same community for 20 years? Is customer satisfaction key? Write about why your intended audience should consider placing their insurance needs with your agency. Include the keywords your audience will be searching for to find you and the business you want to write. Create unique content to engage visitors to spend time on your site and ultimately contact you.

Website Options: Info, Domain, Logo Do you have a domain name? (Example www.bestinsurance.com) To launch the website, we can send you the IP address of the site or we can set it up for you. **For us to make the needed DNS changes, we will need the log in info for your domain registrar or hosting account. Domain Registrar account username: __________________________ password: _________________________

__________________________________________________________________________________________________________

If not, do you have an idea of what you would like? Check the availability of domains at www.godaddy.com. We recommend a .com or .net domain name. You will need to register your domain through a domain registrar such as Go Daddy.

__________________________________________________________________________________________________________

Do you already have a logo? If not, do you want to have one created? The AgencyThrive Logo Design Service is an affordable way to improve your agency’s distinct visibility and brand. With the AgencyThrive Logo Design Service, you will receive a custom designed agency logo in various file formats including JPG and GIF formats, for web use and viewable with any browser, Adobe Illustrator (AI) for use with print vendors, web designers and silk screen printers. *$50 one-time logo design fee, paid upfront

__________________________________________________________________________________________________________

Service Area - REQUIRED What Cities do your customers come from?

For Internal Use Only Agency: ______________________________ Cust#: ____________ Date Received: ______________

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Website Options: Info, Domain, Logo (cont.) Do you have existing business cards or other printed material we need to match?

Yes (If yes, please email a copy to us.) No

Do you have ideas of the colors to be used, and colors you don't like? Please provide an example of color or the HEX, RGB or

HSV code. ________________________________________________________________________________________________

What quote forms would you like to include? If you would like us to include quote forms, please let us know which forms you would like on the website, i.e. General Insurance (Basic contact form capturing contact info + types of insurance needed checkboxes), Health Insurance Quote Form, Homeowner Quote Form, Auto Quote Form, Commercial, etc.

General Insurance Quote Form Commercial Insurance Quote Form

Home Insurance Quote Form Auto Insurance Quote Form

Life Insurance Quote Form Health Insurance Quote Form

Other _______________________ Other _________________________

Are you an AccuAuto customer? If your agency uses the AccuAuto web rater, would you like to include Consumer Portal on your website? Consumer Portal is the Instant Auto Quote generator that allows customers to immediately get an online quote on Auto Insurance. You will receive an email and/or text message when a quote is completed. The quote data is saved in your AccuAuto database and is ready to pro-cess into a policy. The consumer only sees the top three quotes and no company names. If you are not a current AccuAuto cus-tomer and would like more info, let us know. $40/month for AgencyThrive website customers

Yes No Current Consumer Portal Customer

Photos Provide at least one photo. Consider a storefront picture, individual staff photos, group staff photos and photos for the various lines of business you write. If you have purchased stock photos, please send those as well.

Make a Payment Page If you would like a make a payment page, please list all carriers to be linked. We will include the carrier logo and link the logo to the carrier make a payment page.

Carrier __________________________

Carrier __________________________

Carrier __________________________

Carrier __________________________

Carrier __________________________

Carrier __________________________

Carrier __________________________

Carrier __________________________

Social Media Business Pages Please provide the URL for each. If you do not have that particular social media link, please list "N/A". For AgencyThrive Web Marketing, if you have existing social media account you would like us to take over, we will need account log in info.

Agency Facebook Business Page Address:

__________________________________________________________________________________________________________

For Internal Use Only Agency: ______________________________ Cust#: ____________ Date Received: ______________

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Social Media Business Pages (cont.) Please provide the URL for each. If you do not have that particular social media link, please list "N/A". For AgencyThrive Web Marketing, if you have existing social media account you would like us to take over, we will need account log in info. Agency Twitter Page:

__________________________________________________________________________________________________________

Agency Google Plus Page:

__________________________________________________________________________________________________________

Agency LinkedIn Page:

__________________________________________________________________________________________________________

Agency Yelp Page:

__________________________________________________________________________________________________________

Agency YouTube Page:

__________________________________________________________________________________________________________

AgencyThrive Customers Web Marketing Plan Photos - REQUIRED Google Plus will allow up to 10 photos and 5 videos Provide at least 5 photos for the AgencyThrive Web Marketing Plan. Consider a storefront picture, individual staff photos, group staff photos and photos for the various lines of business you write. If you have stock photos you would like to use, please send those as well. Carrier Appointments – Personal Auto Insurance Carriers Can your potential customers find you on the Progressive find an agent page? Can your potential customers find you on the Infini-ty Agent Locator page? These are just two examples of potential backlinks. We will check the carrier websites for opportunities to be listed on those that provide agent locator services online and include agency website links in the results. The number of backlinks is one indication of the popularity or importance of a website or page (for example, this is used by Google to determine the PageRank of a webpage).

Carrier _____________________________

Carrier _____________________________

Carrier _____________________________

Carrier _____________________________

Carrier _____________________________

Carrier _____________________________

Carrier _____________________________

Carrier _____________________________