General Information— Page 1 of 2First Name ___________________________ Last Name __________________________________________ Address: _________________________________________________________________________________ City:________________________________ State___________ Zip Code ___________________________ Phone (___ ___ ___) ___ ___ ___ - ___ ___ ___ ___ Mobile (___ ___ ___) ___ ___ ___ - ___ ___ ___ ___ Email: ___________________________________________________________________________________ Free Report/Follow-up [ ] Yes, please sent the free report for me when people call for the free report, $2.50/report The reports are personalized with both your name & contact information, they are printed on 24# linen ivory resume paper, and mailed in a matching hand addressed envelope. The return address reads “Financial Information Service The Free Report You Requested” in red. [ ] Send a generic free report, no name or phone number. [ ] Personalize the Free report with my name & Number. Agent Name on Report: ____________________________________________________________________ Contact Number on Report: ________________________________________________________________ [ ] Yes, please send me 25 generic free reports on 24# linen ivory resume paper, with matching envelopes so, I can mail them myself - $19.95 Call-To-Action Numbers [ ] Yes, I would like you to provide me with a unique number for each of my mailings—for FREE By having a unique number on each of your mailings we’ll be able to track the response rates for your individual mailings, and adjust your marketing so that you get a consistent 1-1.5% response rate. [ ] I have listened to the information hotline recording at 1-888-221-3638 and approve it. [ ] I would like to record my own message for FREE, please email me instructions. [ ] Just forward all calls to my own number at __________________ and track the responses Email the leads to me at: _________________________________________________________ [ ] I want my toll-free number printed on the cards, I don’t want to track the response rates Free Report Hotline _________________________________________________________ Billing Information CC Type: Visa MasterCard Discover American Express Credit Card Number_____________________________________________________________________ Exp. ____ ____ / ___ ___ ___ ___ (mm/yyyy) Name On Card ___________________________________ Signature _____________________________________________________________________ CVV ______ All orders are final. No refunds on mailing or postage. Order Information ____ Silver Plan --Send 500 postcards a week, until I say stop 1,000 postcards will be sent to you every 2 weeks—$225.00/wk ____ Gold Plan --Send 1000 postcards a week, until I say stop every week 1000 postcards will be sent—$450.00/wk ____ Platinum Plan -- Send 2,000 postcards a week, until I say stop every week 2000 postcards will be sent -- $900.00/wk ____ I’d like to place a one time order of [ ] 1000 postcards $450 includes weekly setup fee [ ] 2000 postcards $900 [ ] 3000 postcards $1350 [ ] 4000 postcards $1800 [ ] __________ postcards @ $0.45/card - Total $_______________ To order lists call Russ Jones at 435-563-4749 Shipping Information [ ] Yes, please ship the postcards to me, addressed, stamped, rubber banded, and ready to be mailed. Just drop them in your local blue mailbox, give to your mailman, or drop off at your local post-office. Postcards are shipped Priority Mail (2-3 days) to you and costs $9.95 per thousand, and $14.95 for two thousand. [ ] Please mail my postcards for me at your post-office Address: _________________________________________________________________________________ City:_______________________________ State___________ Zip Code ___________________________ Postcard Campaign to be mailed [ ] Yes, Please send the postcard that is pulling best for my area & my list, continually adjust the postcards so that I get a 1-1.5% response rate. [ ] No, I would like to select a postcard to be mailed CD Postcard campaign #_____ (1 - 5 click for more info.) IRA Postcard campaign #_____ (1 - 3 click for more info.) Send CD #______ Send IRA #______ If you are selecting an individual postcard select which version you want: [ ] Send First postcard (urgent) [ ] Send Second Notice [ ] Send Final Notice To place your order, fax this form to 888-218-9018 or call Leibel Sternbach at www.RadicalPrinting.com 888-218-9017 to schedule your mailings. |