Marketing Run Intake Form
Capture our marketing run potential partnerships contact info and key observations.
Type of Opportunity
D2C
Fleet
Other Local Partnership
Business Type
Please Select
Food & Beverage
Electronics
Retail
Construction
Real Estate
Transportation
Hotel & Restaurants
Information & Technology
Manufacturing
Business Name
POC Name
First Name
Last Name
Title
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
How many Employees?
How would the owner prefer to communicate with our team?
Text
Email
Both Text/Email
Upload Photos (Business Card, Signage, Promotions, etc)
Key Observations/Note
Rate the potential of partnership in the future
1
2
3
4
5
1 Star = Low/Unlikely - 3 Star = Somewhat Likely - 5 Star = Extremely Likely
Submit
Should be Empty: