| Your Name (first and last, please): |
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| Email Address: |
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| What is the name of your business: |
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| What is the URL to your website? |
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| If you have a business page on Facebook, what is its URL? |
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| What month(s) do you plan on participating in? |
August - Promos due 8/16/10
September - Promos due 9/13/10
October (Holiday) - Promos due 10/04/10
November (Holiday) - Promos due 11/01/10
December (Holiday) - Promos due 11/29/10
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| What type of samples will you be submitting -- Soaps, Candle Tarts, Pendants, Earrings, Photos/Art, etc? |
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| How many samples are you planning on donating for the boxes? |
25
50
75
100
150
200
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| Do you have a banner ad that measures 125px by 125px? |
Yes - Use my existing one.
Yes - I will send it to you.
No - But I understand I need one.
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| Do you understand that you need to supply us with a picture of your samples? |
Yes - Sending similar samples as before so use existing photo.
Yes - Will send photo.
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| How did you learn of the Little Black Box? Were you referred to us? |
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| Signing up to participate in The Little Black Box is a contract with us and acknowledges that you are serious in your participation. If you can no longer participate, you need to let us know as soon as possible. Businesses who do not communicate with us and fail to send in any samples will not be allowed to participate in the future. |
I understand
I do not understand
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