COMPANY INFORMATION
Company Name
*
DBA (Doing Business As)
*
Website
*
Years in Business
*
Type of Business
*
Owner / Operator
Broker
Both
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Primary Contacts
Main Contact Name
*
First Name
Last Name
Main Contact Email
*
example@example.com
Main Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Quotes / Pricing Contact
Quote Contact Name
*
First Name
Last Name
Quote Contact Email
*
example@example.com
Quote Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Booking / Scheduling Contact
Booking Contact Name
*
First Name
Last Name
Booking Contact Email
*
example@example.com
Booking Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
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FLEET DETAILS
Number of Trucks Owned
*
Total Trucks Accessible (including partners)
*
Truck Types Offered
*
Static Billboard
Digital LED
Projection
Other
If Digital LED – Screen Size (in feet)
If Digital LED - Screen Resolution (in pixels)
Number of Sides
*
1 Side
2 Sides
3 Sides
3 Sides +1
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Coverage & Markets
Primary Cities / Markets
*
States Covered
Coverage Area Without Additional Fees
*
Coverage Area With Additional Fees
*
Travel Fee Structure
*
Lodging Required for Out-of-Market Jobs
*
Yes
No
Per Diem / Food Required
*
Yes
No
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Pricing Structure (Wholesale Preferred)
Standard Hourly Rate ($)
*
Daily Rate ($)
*
Weekly Rate ($)
*
Wholesale Rate (Your Net to Vendor)
*
(IMPORTANT)
Volume Discounts Available
*
Yes
No
If Yes, Describe Discounts
Overtime Rate (after X hours)
*
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Campaign Requirements
Minimum Campaign Length (Hours)
*
Minimum Booking Notice
*
Please Select
Same Day
24 Hours
48 Hours
72+ Hours
Always Try Us
Maximum Hours Per Day
*
Operating Hours
*
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Capabilities & Add-Ons
Audio Capability
*
Yes
No
GPS Tracking Available
*
Yes
No
Live Reporting / Screenshots
*
Yes
No
Driver Uniform / Branding
*
Yes
No
Flyer / QR Code Distribution
*
Yes
No
Can Follow Custom Routes
*
Yes
No
Can Park for Static Exposure
*
Yes
No
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Capabilities & Add-Ons
How Fast Can You Deploy a Truck?
*
Same Day
24 Hours
48+ Hours
Can You Handle Large Multi-Truck Campaigns?
*
Yes
No
Are you willing to operate under strict white-label conditions?
*
Yes – No vendor branding will be displayed or promoted under any circumstances
Yes – With prior approval only
No
Are You Open to Revenue Share Deals?
Yes
No
Not Applicable
Willing to Offer Category Exclusivity?
Yes
No
Not Applicable
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Compliance & Insurance
Upload Proof of Insurance
Browse Files
Drag and drop files here
Choose a file
IF YOU DOT DO IT NOW, IT WILL BE REQUIRED PRIOR TO ANY CAMPAIGN LAUNCH
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Do You Handle Local Permits?
*
Yes
No
“I confirm all operations comply with local laws and regulations.”
*
Yes
I acknowledge and agree that I am not permitted to post, share, promote, or disclose any campaign, client information, routes, or creative content associated with The Mobile Billboard Company, powered by ILUM LLC without prior written consent. This includes but is not limited to: Social media posts; Email marketing; Text messages; Website content; Case studies or portfolios. I understand that all campaigns are considered confidential unless otherwise approved in writing.
*
Yes
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Truck Media
Upload Truck Images (Minimum 3)
*
Browse Files
Drag and drop files here
Choose a file
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Upload Video (Optional)
Browse Files
Drag and drop files here
Choose a file
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Upload Sample Campaign Footage
*
Browse Files
Drag and drop files here
Choose a file
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PAYMENT TERMS
Accepted Payment Methods
*
ACH
Wire
Zelle
Credit Card
Check
Payment Terms
*
Please Select
Upfront
Net 7
Net 15
Net 30
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Additional Notes
Anything We Missed?
Please verify that you are human
*
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