Amazing Clicks Insertion Order
Please fill out every field completely. A poorly constructed landing page is a disservice to your customer! A little effort in the beginning will ensure a long and effective relationship. Visit http://www.myglobalprofile.com/tree-of-life-landscape to see a sample landing page that you can use as a reference for completing this information.
Publication Information
Publication City:
Rep Name:
Rep Phone:
Rep Email:
Business Information
First Name:
Last Name:
Business Legal Name:
Street Address:
City:
State:
Zip:
Telephone:
Fax:
Email Address:
Business Website
Enter www.nowebsite.com if no website available
Business Email:
Targeting Information
Select One: City -or- DMA -or- State -or- Radius -or- NationWide
If City selected, enter city name:
List DMA or states served:
If Radius is selected, enter the mile radius served around the business' physical street address. Enter radius served in miles (Numbers Only):
Miles
Geo-Modifiers. List all the city/town names that you want to appear along side of your Ad Word Title, for example: Dallas Tax Attorney. This list of city and town names will override any default list generated by ad copywriters and will be reflected in the 'Geographic Market Areas' section on Merchant Center reporting. This is not a required field.
Additional targeting information. Provide as much information as possible:
Suggested Keywords (Separate with commas):
Call Tracking Information
Select One: Local Number -or- Toll-Free
Requested Area Code:
Forward Calls To:
Landing Page Information
Display Map to Business on Landing Page: Yes -or- No
Business Overview:
Provide a brief but compelling description of your business. (TWO PHOTOS ALLOWED)
Accepted Formats: .gif,.jpg,.png Max File Size: 200kb
Uploading a new file will overwrite the previous file.
Products & Services:
List, in detail, the products and services your business offers. (TWO PHOTOS ALLOWED)
Accepted Formats: .gif,.jpg,.png Max File Size: 200kb
Uploading a new file will overwrite the previous file.
Brands:
List, in detail, the brand names your business carries. (TWO PHOTOS ALLOWED)
Accepted Formats: .gif,.jpg,.png Max File Size: 200kb
Uploading a new file will overwrite the previous file.
Current Specials:
List any promos, coupons or specials you would like to highlight. (TWO PHOTOS ALLOWED)
Accepted Formats: .gif,.jpg,.png Max File Size: 200kb
Uploading a new file will overwrite the previous file.
Time Zone: Eastern -or- Central -or- Mountain -or- Pacific
Business Hours:
Monday:
Open:
Close:
Tuesday:
Open:
Close:
Wednesday:
Open:
Close:
Thursday:
Open:
Close:
Friday:
Open:
Close:
Saturday:
Open:
Close:
Sunday:
Open:
Close:
Payment Methods (Check all that apply):
Cash
Debit/ATM Card
Check
Traveler's Check
Visa
MasterCard
American Express
Discover
Additional Notes:
Any additional information that may help in the construction of the landing page: coupons or special offers you want to include, things that make your business unique, awards you have received, testimonials, landing page layout instructions, logos, etc. (THREE PHOTOS ALLOWED)
Accepted Formats: .gif,.jpg,.png Max File Size: 200kb
Uploading a new file will overwrite the previous file.
Billing Information
Use Business Information for Billing Information
First Name:
Last Name:
Business Legal Name:
Street Address:
City:
State:
Zip:
Telephone:
Fax:
Email Address:
Campaign Information
Campaign Type: Guaranteed -or- EZ Budget
Amazing Clicks Guaranteed (select one):
240 Clicks/Term
6-Months at $169.99/Month
480 Clicks/Term
6-Months at $299.99/Month
900 Clicks/Term
6-Months at $499.99/Month
1500 Clicks/Term
6-Months at $799.99/Month
1950 Clicks/Term
6-Months at $999.99/Month
480 Clicks/Term
12-Months at $159.99/Month
960 Clicks/Term
12-Months at $279.99/Month
1800 Clicks/Term
12-Months at $479.99/Month
3000 Clicks/Term
12-Months at $769.99/Month
3900 Clicks/Term
12-Months at $969.99/Month
"Guaranteed Clicks" product is based on the term and price above, not a monthly term and price. The number of Guaranteed Clicks set forth on this insertion order shall be equal to the number of aggregate clicks on customer's campaign over the course of the term specified.
Amazing Clicks EZ Budget (select one) - All budget campaigns are 6-months term
Monthly Budget: $1000 -or- $1500 -or- $2000 -or- Other
If Other Selected, enter maximum Amazing Clicks EZ budget amount here:
$
Total Campaign Investment (Monthly budget X6 months)
$
Campaign Name:
Campaign Start Date (Allow 7 business days from submission. Format: mm/dd/yyyy):
Campaign URL (If applicable):
Enter www.nowebsite.com if no website available
As an authorized representative of my publication, I am requesting the campaign and landing page above. My customer has signed the printed version of the Amazing Media insertion order and I have collected his / her billing information. I understand that my paper will be solely responsible for all billing and collections for this campaign.
Once you have completed and submitted the form, a "Your Amazing Clicks Insertion Order submission is complete." message will be displayed. If you do not see this message, please contact customer service at 850-833-2648.