Local Business Questionaire

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First Name*

Last Name*

E-Mail Address*

Web Site URL

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Business Phone

Please briefly describe your company, industries & markets served

What are your primary products/services sold

Do you have an email or direct mail database of prospects and/or clients?

	Yes, I have an email database
	Yes, I have a direct mail database
	I have both
	I do not have a client database

If you have a database, how many subscribers you currently have?

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Thanks for getting in touch. I'll get back to you as soon as I can.

Warm regards

Rocky

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