Marketing Consultants (individuals) Input Form

This form allows you to provide users of the Info-Xone with information about your Marketing Consultancy services. The InfoXone deals with thousands 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:

Name:
Organization, if appropriate:
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 Media Consultancy	Media Planning	Media Analysis
Advertising	Editorial
Training in Media Skills

Other (Please specify):

Please indicate industrial 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 do you employ?

None	1-2
3-5	More than 5

List your major clients:

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

Less than £50,000

£50,001-£100,000

More than £100,000

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: July 25th, 1999