Advertising Agencies Input Form

This form allows you to provide users of the Info-Xone with information about your Advertising Agency. The InfoXone deals with a large number of enquiries every day, so it is in your interest to be accurate and to keep the information up-to-date.

Please provide the following contact information:

Organization:
Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal code:
Country:
Work Phone:
FAX:
E-mail:
URL:

Please indicate areas of expertise (tick as many as are applicable):

General Advertising	Consumer Advertising	Industrial Advertising
Press Advertising	Radio Advertising	Television Advertising
UK Advertising	European Advertising	Global Advertising

Other (Please specify):

Please indicate the sectors in which you have been active (tick as many as are applicable):

Agriculture	Arts	Broadcasting
Building/Construction	Business/Services	Charity
Clothing	Education	Electronics
Engineering	Financial Services	Food and Drink
Government	Health/Pharmaceutical	IT
Leisure/Travel	Manufacturing	Media
Professional Services	Property	Retail
Sport	Telecommunications	Transport
Utilities

Other (Please specify):

How many people are employed by your company?

Less than 5	6-10	11-20
21-50	51-100	More than 100

List your major clients:

What was your company's turnover last year (UK Sterling)?

Less than £250,000	£250,001-£500,000	£500,001-£1,000,000
£1,000,001-£5,000,000	£5,000,001-£10,000,000	More than £10,000,000

List the names and job titles of the top five senior executives:
Any other information you would like included:
Any comments to help us:

For quality control and checking purposes, please give:
Name of respondent:
Job Title of Respondent:

Panarc International reserves the right to check, edit or reject any submission.

Last revised: November 15th, 1999