FREE QUOTE REQUEST FORM

Please complete each of the fields below in order for us to provide the most accurate quote for your data request.


Contact & Company Information

First Name: Last Name:

Company Name: Title:

Address:

City: State: ZIP code:

Phone (including area code): E-mail:

Type of company:

Primary customer base: consumer business both


How did you learn about Targeted Marketing Solutions?:
Search engine
Friend or colleague
Link from another site
Other, please specify


Data Requirements:

Type of list(s):
New Mortgages (check selected geographic areas below)
New Businesses (Richmond City, Chesterfield County, and Henrico County combined)
Both


Subscription type:
Single list purchase
Weekly updates*

NOTE: There is no long-term obligation under this plan. You may cancel at any time.
You will only be billed for data received prior to cancellation notification.


Start date - New Mortgages: (mm/dd/yy format)

Start date - New Businesses: (mm/dd/yy format)

End date: (mm/dd/yy format)
NOTE: End date is only required for one-time list requests. All other requests will continue on a weekly basis until cancellation notification is received.

New Mortgage Lists(check all that apply):

Richmond City
Chesterfield County
Henrico County
Hanover County

Please indicate which of the following additional areas you might be interested in receiving monthly updates for:
Petersburg City
Colonial Heights City
Powhatan County
Goochland County
Amelia County
New Kent County
King William County
none of the above
Other1:
Other2:
Other3:



Please be sure to provide any additional information that will help us to better understand your business needs and specific data requirements in the space provided below.



Preferred method of contact: email phone



2002 copyright - Targeted Marketing Solutions
P.O. Box 35346, Richmond, VA 23235-0346
Tel: 804.393.0488