Thank you for your interest in Bench Billboard.
Your Name
Your Title
Decision Maker's Name (if different)
Decision Maker's Title
Company Name
Address
City
State
Zip Code
Phone Number 1
Phone Number 2
Fax Number
Email Address
If not obvious, what does the business do?
In the last year, what average monthly dollar amount was spent on advertising?	None $1-$99 $100-$249 $250-$499 $500-$999 $1,000-$1,999 $2,000-$4,999 $5000-$9,999 $10,000 and Over
When do you need to begin some new advertising?	now 1 Month 2-3 Months 6 Months 1 Year or More
The advertising information below is helpful in our consulting with you on your needs.
What types of advertising had your business done in the past year? Check all that apply.
Bandit SignInternetCable Television Bench AdMagazineTransit (bus) BillboardMovie ScreenTransit Shelter CouponNewspaperVehicle Signage Direct MailRadioYard Signs Door HangerSpecialty AdsYellow Pages Fax BroadcastBroadcast TelevisionNone
What kinds of advertising was a success for your business in the past? Check all that apply.
Bandit SignInternetCable Television Bench AdMagazineTransit (bus) BillboardMovie ScreenTransit Shelter CouponNewspaperVehicle Signage Direct MailRadioYard Signs Door HangerSpecialty AdsYellow Pages Fax BroadcastBroadcast TelevisionUnknown
What geographic areas to you need to target?
Describe the kind of people you need to reach. (Income, gender, ethnicity, lifestyle, etc.)
Describe how you feel bench advertising can be of help to your business.
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