Barter Advertising Solutions Consultation Request Form

Name*

First NameLast Name
Company Name*
Type of Business*
Phone*
E-mail Address*
Website*
How did you hear about us?*
Preferred Contact Method*

EmailPhoneEither is fine
What would you like to trade to us for Advertising?*
Any additional comments regarding what you would like to trade to us for Advertising
Define Your Target Market and Audience
Define Your Target Geography*

LocalRegionalNationalInternationalBest ValueOther
Additional information about your target area(s)*
i.e. specific cities, states, regions, countries, or other information
Who is your target market*

ConsumersBusinessTo Be Determined
If you are trying to reach Consumers, gender is primarily:
What age group(s) are you trying to target?

18-2425-3435-4445-5455-6465+Don't know at this time
If you're trying to reach Consumers, median household income is:

$0-$25,000$25,000 - $50,000$50,000 - $100,000$100,000 - $250,000More than $250,000Don't know at this time
If you are trying to reach Businesses - please describe the types of Businesses and Industries you are trying to reach:
What are the annual sales of the Businesses you are trying to reach? (check all that apply)

$0 - $100,000$100,000 - $500,000$500,000 - $1,000,000$1,000,000 - $5,000,000$5,000,000 - $10,000,000over $10,000,000Don't know at this time
What are your primary reasons for advertising at this time?*

Awareness & BrandingLead Generation to support Sales peopleDirect ResponseCampaignEventSpecial SaleOther
Additional information/comments about your advertising objectives
Do you currently have an ad agency of record agreement?*

YesNo
Is Your Creative / Ad Copy / Commercial Ready?*

YesNoPartially
What types of advertising are you interested in at this time*

TelevisionRadioInternetMagazinesNewspapersOutdoorTransitAd Specialty (custom logo items, premiums/promotions)Sponsorships or Product Placements
Additional Comments about Media Formats*
How much cash did you spend on advertising last year?*
How much in barter did you spend on advertising last year?*
What is your current cash media budget?*
What is your current barter media budget?*
Over How Many weeks?*
When would you like to start your campaign ?*
Please tell us what types of advertising have worked for you in the past?*
Please tell us what types of advertising have not worked for you in the past?*
Any additional comments or information you would like to add
You may upload document(s) you wish us to review

Upload a File

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You may upload document(s) you wish us to review

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Define Your Target Market and Audience