Direct Connect Proposal Request

November 05, 2011

Name: *

Email address: *

Phone number: *

Company name:

Purpose of your campaign:

Target audience:

Geographic market:

Expected campaign duration:

Estimated number of tags:

Tag type:

Standard

Die Cut

Product Samples

Tag size:

2x4.5

2.5x4.5

3x5

Custom Size

Coding:

QR Codes

Bar Codes

Unique Promo Codes

Custom URL

Is this campaign going to be integrated with other media or campaigns? If so please describe.:

Direct Connect Services Requested:

Campaign Strategy: assistance with creating the offer or campaign strategy?

Creative Design: will you be using our services for tag design and execution?"

Web Design: will you be using our services for custom landing page development

Printing, stringing and transportation: will you be using our services?

Measurement: will you be using our services for tracking redemption & ROI?

Need Assistance with any other services not mentioned above? If so please describe.:

If there are any additional questions, clarifications or comments please provide below.: