Business Name *
Contact Person *
Address *
Phone *
Air Date
Where will this commercial air?
Will you be receiving co-op funding for this commercial?
What aspect of your business would you like to promote?
Who are you trying to reach?
Do you have a commercial/script idea in mind?
Does it involve people, specific items, locations, or images?
Is there more than one location to be shot?
Would you like anyone to appear on camera with a speaking role?
Do you have a jingle?
Do you have a logo?
Do you have a slogan?
Describe your business, products, or services
Information you would like included in your script
If you were to get one specific result from your advertising, what would it be?
Do you plan on producing more than one commercial either now or in the future?
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