Keenote Marketing and Media - Market Analysis and Marketing Strategy

Below is a request form which covers all the basic selections available on our Business-to-Consumer lists. Not every section of this form needs to be completed, but at least one area of geography, one type of list and any other specific selections you would like should be completed in order to help us serve you. After completing and submitting the below form one of our list experts will reply by email or phone to give you the total number of records available that meet your request, as well as the different cost options available for that list.

If you would prefer to call us at 800-728-8192 to speak to a live representative about these selections or any other special requests or assistance you may need, please feel free to do so. If you are unsure of the type of list that would best suit the needs of your campaign, please call us for assistance.

Full Business Name:
Full Name and Title:
Business Street Address:
City:
State:	ZIP Code:
E-mail Address:
Telephone number:	(include area code)
Best time to call:
Fax number:
Type of product or service:
Referred by:
Keenote representative I spoke to:

CHECK ALL THAT APPLY:

Consumer List (includes names and addresses):($125.00 min order)

Note: /m = per 1,000 records

$26.00/m (one time use base)

$48.00/m (unlimited use base)

Select free by Geography:

Specify 5-digit ZIP codes:
Specify States:
Specify Counties:
Specify Radius of Zip or Address:
Specify Metro Areas:
Specify Phone Area Codes:
Specify Other Geography:

FREE Select Items (please specify):

Refinement Select with each having it's own associated cost:

Standard Output Media:

Email - Comma Delimited File Format - Free
CD Rom Delivered via Standard Mail - Add $5.00
CD Rom Delivered via Fed-Ex Overnight - Add $35.00
Email - Microsoft Word Label File Format for your Labels (such as Avery) - Add $25.00

Specialty Consumer Lists: