Mazda CX-90 Village Influencer Placement Form

Mazda CX-90 Village Influencer Placement Form

This form will provide all the information needed for Mazda loan deliveries and collaborations.
Influencer and Vehicle Information
Vehicle Model
Vehicle VIN*
DriveShop Office for Loan Delivery*
Is the Vehicle Currently in our Fleet?*

YesNo
Loan Start Date*

MonthDayYear
Date
Loan End Date*

MonthDayYear
Date
Preferred Delivery Time*

MorningMid-DayAfternoonNo Preference
Influencer Full Name (as it appears on license)*

First NameLast Name
Influencer Address for Vehicle Drop-Off and Pickup*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Influencer Primary Email*
Influencer Phone Number*

Area CodePhone Number
Influencer Driver License Number*
Influencer Driver License Expiration Date*
Influencer Driver License Issuing State*
Social Media and Vehicle Use Information
Link to Influencer Main Channel
Influencer Brief Upload

Browse Files

Cancelof
Influencer Use of Vehicle*
Estimated Miles Driven*
Additional Notes
Submitted By

First NameLast Name
Submitted by Email
example@example.com
Should be Empty:

Social Media and Vehicle Use Information