Business Promotion Form

Collect contact details and responses from customers interested in a business promotion, including how they heard about it and their prior experience with the brand.

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Page 1

Full Name*

Nombre

Apellido

Email*

Phone Number*

Address*

Dirección

Ciudad

Estado / Provincia

Código postal

Page 2

How did you hear about this promotion?*

Social media Email Friend referral Advertisement Other

Please specify*

Page 3

What are you interested in?*

Purchasing a product Inquiring about a service Attending an event Other

Please specify*

Have you shopped with us before?*

Yes No

If yes, please rate our products/services*

Not likely

1 2 3 4 5 6 7 8 9 10

Very likely

I have read the above instructions and I*

Agree and wish to continue Agree to be contacted Do not agree

Name of Sales Executive

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