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The Vernon Advocate

Personal/Company Information Form

 

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Your Name (required):   
Telephone (required):   
Address #1  
Address #2  
City, State, Zip  
E-mail address (required) ("none" if none):  
Company Name  
Industry  
Your Title  
Web Site Address  
Status of Company:    

New Startup

 

Want to increase sales and profits

 

Want to grow the company

 

Need help in turning around performance

 

Other (please describe)

 
Are you interested in a Specific Vernon Advocate Service? (If "Yes" which sdervice?)   Yes   No  
   
Marketing Service
 
Public Relations Service
 
Book & eBook Writing & Publishing Service
 

Media Coverage Service

 

Internet Services

 
Other service (please describe the service you need)
 
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If "Yes" what is the referrers name?  
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