New Mailchimp Account Setup

BASIC ACCOUNT INFO
Email Address*

This will also be the username.
Password*
Password Requirements:
One lowercase character
One uppercase character
One number
One special character
8 characters minimum
Company/Organisation*
Contact Name*
Phone
Address*
Street Address Address Line 2 City State Postcode Country
Website URL*

Where did people opt in to this list?
LIST AND CAMPAIGN SETTINGS
Do you need a signup form on your website?*
- Yes
- No
Form Fields*
- Email Address only
- Name, Email Address
- First Name, Last Name, Email Address
- Other
Please specify the required signup form fields.*

Must include email address field.
For what purpose will you use your email campaign?

E.g. New blog notifications for subscribers, monthly newsletter, etc.
Campaign From Name

This is the name your emails will come from. Use something your subscribers will instantly recognize, like your company name.
Campaign From Email Address

This address receives reply emails. Check it regularly to stay in touch with your audience.
Social Media Profiles
Please list each social media profile with URL that you would like included in your campaign footer.
PLEASE NOTE:

Your account will require activation before initial setup can be completed.

You will be sent an activation email from MailChimp.

Please forward this email to admin@makeweb.com.au, so we can continue the account setup.
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.