The Burrow | Media Customer

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Media Customer

Media Customer Consultation Request Form

1. Business Information

Business Name

Business Address

City

State

Zip Code

Best Contact Person:

Email Address

Phone Number:

Website (if available):

2. Signage Interests

Please select the type(s) of LED display you’re interested in:

HD SeriesUHD SeriesX SeriesR SeriesC SeriesT SeriesS SeriesFC SeriesS SeriesPD Series Other:

Number of Units:

Size Preferences (in ft/in):

Placement Location:

3. Marketing Interest

I’m interested in learning more about the following services (Check all that apply):

Website DesignLanding page CreationCampaign ManagementPaid Advertising (Google, Social Media, etc.)SEO ServicesContent DevelopmentBusiness Card & Print MaterialsBusiness OptimizationGeo-TaggingE-Commerce Drop Site Setup

4. Customization Details

Double / Single Sided:

Double Single

Mounting Type:

Wall MountFree-standingRaceway

Lighting System Preference:

Artwork/Logo Ready?:

Yes No

Additional Instructions or Special Requirements:

Consultation Scheduling

Preferred Date:

Preferred Time:

Start

Mode of Meeting:

Phone Video Call

5. Agreement & Authorization

By submitting this form, I confirm my interest in receiving a consultation regarding Burrow Media’s LED signage solutions. I understand that final pricing and project timelines will be discussed during the consultation meeting

Signature:

Date:

At The Burrow, we aim to be the angel investors of brick-and-mortar dreams. We’re here to support entrepreneurs.

(920) 257-3547
marcus@theburrowwi.com

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