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Subject

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How did you hear about AXIA?
---Internet SearchWord of Mouth/ Reputation/ ReferralMedia CoveragePhone DirectoryOther (please specify)

Which industry sector experience do you require?
---Consumer RetailFinancial ProductsGovernment/Non-profitHealth CareIndustrialProfessional ServiceTechnologyother (please specify)

What type of services do you need?
---Advertising campaignBusiness-to-BusinessConsulting & StrategyCorporate CommunicationsCreative & Design SolutionsCrisis ManagementExecutive OutreachEvent Planning and MarketingIntegrated Marketing Planning or DevelopmentInvestor RelationsMarket ResearchMedia RelationsSales CollateralSales EnhancementStrategic PlanningOther (please specify)

What constituency would you like to influence?
---BusinessesConsumersMedia/Trade PressInvestorsOther (please specify)

What type of commitment are you looking for?
---OngoingPartnershipPeriodicalJust this once

What is your timeline to pursue this initiative?
---Within 2 weeksWithin 30 daysWIthin 90 daysWithin six monthsFlexible

What is your anticipated investment in such a marketing program?
---Less than $10,000$10,000 to $50,000$50,000 to $100,000$100,000 to $500,000$500,000 to $1,000,000Whatever it takes

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