Create Order Form 1Account Information2Select Services3Summary Review Account Rep Name First Last Date MM slash DD slash YYYY Contact Name First Last Company Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail Select Service Categories Email Services End User Lists/Self Managed Email Marketing Services Ad Network Email ServicesSelect what email products you need included in this contract8LMedia Standard List Price: $299.00 Quantity: VerticallySocial List Price: $174.00 Quantity: Deal List Price: $124.00 Quantity: Gold Standard List Price: $299.00 Quantity: SmartBlast List Price: $799.00 Quantity: Additional Email ServiesBulk List ManagementHow many email contacts do you have? 0-500 501-2,500 2,501-5,000 5,001-10,000 10,001-15,000 15,001-25,000 25,001-30,000 30,001-35,000 35,001-50,000 Bulk List Price $0.00 Event/Meeting Planners List Price: $0.10 Quantity: Total List Size: 38,000 (Pricing is based by address count) Auto Dealers List Price: $0.02 Quantity: Total List Size: 3,000 (Pricing is based by address count) Hotel List Price: $0.05 Quantity: Total List Size: 8,000 (Pricing is based by address count) Law Enforcement List Price: $0.02 Quantity: Total List Size: 417 (Pricing is based by address count)Coaches/Athletic Directors List Price: $0.01 Quantity: Total List Size: 60,000 (Pricing is based by address count)Real Estate List Price: $0.05 Quantity: Total List Size: 55,000 (Pricing is based by address count)Special OffersBuy 1 Smart Blast Get 1 Free Price: $799.00 Quantity: Marketing ServicesSelect what Marketing products you need included in this contractEmail Creative Price: $200.00 Quantity: Landing Pages Price: $500.00 Quantity: Print Creative Price: $150.00 Quantity: This is per page (1 side)Motion Graphics Videos Price: $500.00 Quantity: Up to 60 seconds with no voice over.Live Action Video Price: $1,500.00 Quantity: Up to 60 seconds with talent and voice overWebsite Price: $4,500.00 Quantity: Pages Included (home, about, distributor tools, contact, FAQ, products, ecommerce)Editorial Content Price: $150.00 Quantity: Charged by the hourRetainer Services Price: $100.00 Quantity: Can encompass any of the services in the marketing section with the exclusion of websites. Charged on an hourly basis (Min 5 hours per month)Media Buying Price: $200.00 Quantity: Charged by the hourMarketing Strategy Price: $200.00 Quantity: Charged by the hourAd NetworkSelect what ad network products you need included in this contract8LMedia Ad Network Price: $20.00 Quantity: Pricing is based on CPMRetargeting Price: $10.00 Quantity: Pricing is based on CPMSubtotal $0.00 Contract TermsEstimate Expiration Date MM slash DD slash YYYY Subtotal $0.00 Contract Type*StandardTrialPay in full - 10%Pay in full - 25%Standard: Equal installments over 12 months Trial: Non-email elements & 3 months of email billed up front Pay In Full: Entire contract billed upon receiptAuto Renewal Active Standard Pricing Outstanding Balance $0.00 Trial Pricing Outstanding Balance $0.00 PIF 10% Discount $0.00 PIF 25% Discount $0.00 Discount Code 10%: PIF10 25%: PIF25 12 Monthly Payments: MON12Total $0.00