Location Placement Agreement Form - Telemarketing
Step 1 of 2
Form Directions
Customer Information
Content for New Div Tag Goes Here
1) First Name - Your First Name
2) Last Name - Your Last Name
3) Street - Your Street Address
4) City - Your City
5) State - Your State
6) Zip Code - Your 5 digit Zip Code
7) Email Address - Your contact Email Address
8) Phone Number - Your Home or Office Contact Phone - 000-000-0000
9) Cell Phone Number - Your contact Cell Number
Placement Information
1) Start Date - Designate the date you wish us to start
2) Placement Method - Will you be using a charity, paying commission, or using both methods.
3) Charity Organization - If using a charity, enter their name.
4) Commission Amount - If paying a commission, enter the percentage amount or numeric amount.
Payment Information
1) Item - Enter the Machine or Item you are having located and placed
2) Placement Fee - Choose Item Fee Charge
3) Quantity - Enter the amount of Machines or Items you are having located and placed
4) TOTAL - Enter Total amount of Payment to be Paid
5) Payment Method - Choose your method of payment
6) Signature - Print your full name
7) I Agree - Hit the button to signify you agree to and understand the agreement
Calculate Total Cost
To get TOTAL Amount - Use Calculator below and Multiply Quantity by Placement Fee
After you have completed the form and have signed your name, press the "I agree" button and you will be forwarded to the Project Focus Form. This form was designed to help us in getting you the best locations available in your area and will help us focus on the businesses you want. After you have completed your Project Focus Form you will be directed to make a payment now on line or to exit the site.
Thank you and we appreciate your business.