Intellirex Marketing

Radio Audio Marketing Request Form

 

Your Name (required)
Your Company
Phone Number (required)
E-mail Address (required)
Your Address (required)
Your City  (required)
Zip Code  (required)
Your State  (required)
Current Web Site (if applicable)

Please note:

  • Please fill in as many fields as possible.

Radio Marketing Setup Request

Radio Marketing Objective: (select as many as applicable)

Television or Cable Broadcast Production

Commercial or Infomercial

Sales/Telemarketing

Electronic Press Video

Internet Online Video

Trade Show

Product Demo/Showcase

Training/Educational

Virtual Sales Person

Other (please specify)

        

 

Radio Transmission Reach: (required)

  USA

  (Select more than one - hold Ctrl key down)

  Canada

  Mexico

  North America

  Russia

  Australia

  Japan

  China

  India

  Other Asian Country

       Specify Country

      

  Europe

       Specify Country

      

  Middle East

       Specify Country

      

  African Continent

       Specify Country

      

  South America

       Specify Country

      

 

 

Radio Product Length: (required)

< 5 min

5 - 15 min

16 - 30 min

31 - 60 min

1 - 2 hours

Not Sure

 

 
Radio Production Timeframe: (required)

ASAP

In Two Weeks

More Than Two Weeks

 

 
Radio Script Writing Needs: (required)

Need Script Writing

Will Provide Your Own Script

Not Sure

 

 
Radio Production Budget: (required)
(required)

 

Additional Services: (select as many as applicable)

Radio Announcer Read (where available)

Condensed Version (Clipped) Filler Radio Ad's

Other (please specify)

       

 

 

Additional Comments
Please provide us with any comments or special instructions for this radio marketing project.

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IMPORTANT NOTICE!

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