ASI Order Form

1. Upload a copy of what the client signed (to ensure order accuracy)

File: {{filename}} delete

Business Name

Contact Name

Contact Phone Number

Contact Email This question requires a valid email address.

Account Manager Name

Account Manager Phone Number

Account Manager Email

Which Interactive Services did they purchase?

Please list the details of what's included in their campaign (if it matches the quote, simply say "as quoted").

How many social networks did they purchase? One is included, they can add additional networks for an extra charge each month.

Brand Booster Details

Number of Impressions Purchased
Please list the number of impressions each month per campaign along with the total number of impressions over the lifetime of the campaign.

Single Campaign Example:
Geofencing 55,000/month
Total 660,000 over 12 months

Multiple Campaign Example:
Brand Booster 50,000/month
Geofencing 50,000/month
Total 600,000 impressions over 6 months

2. What type of Brand Booster?

Standard Brand Booster
Upgraded for extra $ to Dominant Display Blend
(Rare) Downgraded to Basic Blend that only targets by geography and content of the page being viewed

Number of Views Purchased

What is the target campaign start date? *This question is required. Please allow a minimum of 15 days to allow time for ad creation, client approval, set up and audit verification. This question requires a valid date format of MM/DD/YYYY.

Start Date calendar

How long should the campaign run? Example: 2 Months

Are they being billed for ad creation?

What Kind of Location Based Mobile Targeting?

Which Level of Social Media Posting? (All packages are 4 weeks per month)

Websites

The package website comes with 5 main pages. Which 5 pages should be included on the website? Need more than 5 Pages? Check the box below to request a custom quote. NOTE- The advertiser may add additional pages themselves using the Content Management System. Once the new website is approved, we will train them on how to make edits including how to add new pages.

Page 1
Page 2
Page 3
Page 4
Page 5

Does their website require more than 5 pages and you need a custom quote?

Yes- please send me a quote
Yes- I have already received a quote
No- the client understands the website comes with 5 pages

What is the client's current website address?

Please select the option that best fits this client

Please share any notes from meeting with your client that will help us build the site.

Questions or Comments? Anything else we should know?
Make sure you have doublechecked your entries above so that it matches what the client ordered.

To confirm your order, please enter the name of your media company, with city and state.