Please fill out the short questionnaire and application form below so that we can begin with an initial assessment of your business or project.

Note that only items marked with * are required fields, however we encourage you to enter as much information as possible so we can better assess your requirements.

About You

your name:	*
company name:	*
your position:	*
contact email:	*
contact phone:	*	Ext:
mobile phone:
contact fax:
street address:
city/Suburb:
state/Province:
country:
zip code:

 

About Your Business

industry or target market:	*
years in this business:	*
do you already have basic marketing materials?	*	yes no
do you already have a web site?: web site URL:	*	yes no
main source of new clients:
biggest marketing challenge:
do you have written articles available?		yes no
do you have previous experience with the media or public relations? if so briefly describe the results:		yes no

 

Current Marketing Strategies

Include any used within the past 12 months

email newsletter:		yes no
direct mail:		yes no
print advertising:		yes no
writing or publishing:		yes no
referrals or word of mouth:		yes no
personal networking:		yes no
cold calling:		yes no
public speaking:		yes no
trade shows:		yes no
industry events & conferences:		yes no
yearly marketing budget:	*	Please Choose One $2,500-$5,000 $5,000-$7,500 $7,500-$10,000 More than $10,000

 

Almost Finished

how did you find us?		Please Choose One Search Engine Another Web Site Newspaper/Magazine Audio Class Read the Book Word of Mouth Other Source
any comments or suggestions?

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