Partner/Vendor Application Form

Partner/Vendor Application Form

Tell us about you and your company.
iMediaSalesTeam, iMediaAudiences, ReptideMedia DBAs of Iverson Media and Communications LLC.

We’re always looking to partner with top vendors to deliver the best solutions for our stakeholders. If you offer quality services in marketing, tech, media, or business growth, let’s connect!
Representative Name

First NameLast Name
Email Address*
example@example.com
Phone*
Format: (000) 000-0000.
How did you hear about us?*
Company Information
Company Name*
Type of Business*
Address

Street Address

Address Line 2

CityState / Province

Postal / Zip Code
Website
http://www.example.com
Describe the mission and objectives of your organization.
Which of our stakeholders does your offer bennefit?
How will this meeting help our stakeholders? (iMediaSalesTeam Members, Small Business Clients, Virtual Assistant Clients, Media Buying Clients, Agency Clients, Media and Ad Operations Clients, Owners of iMediaSalesTeam/iMediaAudiences.com)
Do you host a podcast? If you host a podcast email info@imediaaudiences.com Subject "Podcast Vendor/Guest Appearance", we may be able to waive the "Lunch & Learn fee" if it’s determined that a member of our team would be a solid guest for your audience. Let me know if that’s of interest!

30 minutes paid "Pitch Me" call ($50) 30 minutes

Hi there if you are a vendor or partner and want to take 30 minutes to discuss why you think your goods or services are going to benefit our stakeholders or family of companies please book a $50 call with me and I'll make sure you get my full attention.

$50.00 Quantity

Total

$0.00

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

iMediaSalesTeam, iMediaAudiences, ReptideMedia DBAs of Iverson Media and Communications LLC.
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Partner/Vendor Application Form

iMediaSalesTeam, iMediaAudiences, ReptideMedia DBAs of Iverson Media and Communications LLC.

Company Information

iMediaSalesTeam, iMediaAudiences, ReptideMedia DBAs of Iverson Media and Communications LLC.