Get Started - Mutual | Titan Digital

Name*

Phone*

Email*

Sales Rep*

Current Website URL:

1. Which website layout did you choose?

Which website layout did you choose?*

Genesis
Solstice
Serenity

Click next link to see Demos: Mutual Sites Demos

2. Contact information for the new website:

Phone Number(s) to Appear on the Website:*

Email Address(es) to Appear on the Website:*

Email Address(es) for Form Submissions:*

Physical Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mailing Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

3. Select which insurance services you provide:

Select which insurance services you provide:*

Other:

4. May we use your current website (if applicable) to create content for your new website?

May we use your current website (if applicable) to create content for your new website?*

Yes
No

5. Do you have any third-party services you would like linked to on your website (like agent login or make a payment)?

If yes, please list them below:

6. Are there any additional pages (aside from those shown on Titan Digital's demo website) that you would like included on your new website?

If yes, please list them below:

7. Which agents or agencies do you partner with?

Please list them below:

8. Names and titles of your board of directors:

Names and titles of your board of directors:

9. Does your mutual company have any social media?

If yes, please list all social media accounts below:

10. Do you want to have the following forms on your website?

Select those that apply:

Request a Quote
File a Claim
Make a Payment
Contact Form

11. Do you need to list any of the following on your website?

Select those that apply:

Annual Reports
Board Documents
Financial Statements

By submitting your phone number do you give permission for us to contact you by SMS text?*

Yes
No

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