New MediaSign TV Order Form

New MediaSign TV Order Form

Marketing doesn't stop once the customer steps foot into the store. Tools like MediaSign TV can take over marketing duties, shopper education, and employee engagement. This subscription and device order form is the opportunity to empower your show room floor to do more for your business. Subscription terms are 2-years for $59.00 per device per month and 3-years for $49.00 per device per month.
Select your Subscription Term:

2 - Year Subscription: $59.00 per month per device3 - Year Subscription: $49.00 per month per deviceMonth-to-Month: $69.00 per month per device
Quantity of devices needed:
What’s included with your MediaSign TV subscription:
1. MediaSign TV Player
2. Subscription to a user-friendly content management portal powered by Rockbot
3. Access to industry-specific vendor product videos, finance offers, vendor promotional assets, and virtual greeters
By signing up, you acknowledge that you have read, understood, and agree to the Terms and Conditions of our service.
Customer Details:
Full Name*

First NameLast Name
Title
Business Name*
NMG ID*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing Contact (if different from above)

First NameLast Name
Billing Contact Email
example@example.com
Billing Contact Phone Number
Please enter a valid phone number.
Shipping Address (if different from above)

Street Address

Street Address Line 2

CityState

Zip Code
Need to ship to more than one location? Please list all shipping addresses below with the quantity of devices required at each location. (example: ABC Store 1234 North Main Street, Winstonville, NC 12345 - QTY 2)
Please select the brands and vendor content you would like to have access to:

AmanaAshley FurnitureBeautyrestBekoCafeCoaster Fine FurnitureDreamCloudElectroluxFlexsteelFrigidaireFurrionGE AppliancesGE ProfileJackson-CatnapperKEF ElectronicsKitchenAidKnickerbocker Bed CompanyLG AppliancesLG ElectronicsLiberty FurnitureMaloufMaytagMonogramNectarSamsung AppliancesSamsung ElectronicsScott LivingSealySertaSharp AppliancesSouthern MotionSpeed QueenStearns and FosterTempur ErgoSmartBaseTempur SleepTrackerTempur-PedicThermadorVaughan-Bassett FurnitureWhirlpool
How did you hear about us?
If Other, please specify:
Signature*

Clear
Should be Empty: