Please note: all fields are mandatory. Enter "n/a" if a field doesn't apply. Direct any questions to Production.

Who are ya?

What's your e-mail address?

For which station is this request?

New or existing prospect?

Business name

Business address

Contact name

Contact phone number

Contact e-mail address

Requested date of completion

Date of presentation

Quantity and length of spots


Format for presentation

Approximate budget requested from client

$

Client's annual advertising budget

$

Projected length of campaign

Type of campaign


Goal of campaign / client expectations

Client's product or service

How much this client has invested with us year-to-date

$

Describe the client's best potential customers:
the 25% who do 75% of their business

Customer gender approximation

male      female

What are the benefits of dealing with this client?

What's in it for the customer?

Who is the client's competition? What sets the client apart?

Do they use a positioning statement or require a specific landmark referral for location?

Have they used radio before?

Is there any print involvement?

Is there any TV involvement?

Any other notes to add to this request? (Optional)