Marketing Assistance List Broker Questionaire Step 1 of 2 50% What type of Campaign is your client executing?* Direct Mail E-mail Telemarketing Multi-Channel Marketing Ad Insert What are your client's marketing objectives?* Investor Relations / Stock Market Awareness / Increased Liquidity Lead Generation Direct product/services sales To open a new investment or banking account Seminars Subscription Sales Brand Awareness / Branding Database Growth / Private Database creation Other What Geographic area is the client targeting?* Entire US By State By SCF By city or county By zip code Are there any other details or demographic information? Name* First Last TitlePhone*Email* Company NameAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code cassonm3diagrpList Broker Questionaire08.30.2014