Premium service - request form

PREMIUM SERVICE REQUEST FORM

IMPORTANT:The * symbol indicates a field that must be filled-in; your form can not be processed otherwise. Please pay careful attention to ensure that all information is correctly entered.

Contact information

Name of company*
Contact name*
Contact email*
Company home page*
Are you based in the EU?*	no yes
If so, are you VAT registered?*	no yes
If so, what is your VAT number?*
Where did you hear about Reach Promotions?*

Software information:

Software name*
Version number*
File size (bytes)*
Price ($)*
Classification*

Additional information:

Do you have website statistics that we can access?
Yes No

Do you have referrer logs that we can access?
Yes No

Services information:

Please indicate which of the following services you may be interested in:

product marketing
search engine optimisation
doorway page creation
Google AdWords management
If yes, please tick if you already have a Google AdWords account.
landing page creation
newsgroup announcements
website usability review
search engine ranking reports
web server log analysis
copywriting
press release
other (please specify)

Any further information:

Run under the parent organisation of SharewarePromotions.

Phone: +44 796 759 5911
Fax: +44 870 442 5271
mail@reachpromotions.com