MAILING LIST RESEARCH FORM

FOR BEST RESULTS, PLEASE FILL OUT THIS FORM COMPLETELY.

1. What is the product or service you are selling? (Include description, costs, benefits, etc.)

2. Who do you want to reach with your mailing? (Include age group, gender, profession, etc.)

3. Where do you want to market your product? (Nationwide or specific states or regions?)

4. How many actual pieces of mail (5,000? 10,000? 100,000?), do you intend to mail now?

5. When do you plan to do this mailing? (Please provide the date or month, even if estimated.)

Please tell us how to get in touch with you:

First Name:
Last Name:
Company:
Title:
Address:
Address:
City:
State:
Zip Code:
Country:
E-Mail:
Telephone:
FAX:
Check this box if you want email addresses
Check this box if you want direct mail addresses



Telephone:
641-472-2332

FAX: 641-472-5729

Address:
508 N. Second St.
Suite #203
Fairfield, IA 52556

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