Prequalify

Want More Information?

Please fill in the following form and we will respond
regarding your area of interest.
All fields must be completed.

COMPANY

STREET

CITY

STATE/PROVINCE

ZIP/POSTAL

PUBLISHED
LOCAL PHONE

-- EXT

FAX #

-- EXT

E-MAIL ADDRESS

WEB URL

CONTACT NAME
(FIRST & LAST)

TITLE

If the business has a P.O. Box, the following information is required in addition to street address information entered above.

P.O. BOX

P.O.BOX CITY

P.O.BOX ST/PROV

P.O.BOX ZIP/POSTAL

PLEASE DESCRIBE YOUR BUSINESS AND MARKET SERVED:

In order to provide exactly what you need, we need just a little more information:

1. Ballpark annual ad budgets spent in the following media areas:

2. Current number of factory authorized dealers:

3. Would you need a process to help you develop and/or increase the size of your dealer referral database? Yes No

4. Do you have a consumer brochure or catalog that you want to make available, 24 hours a day, to your DealerQuik Network callers? Yes No

5. Do you want consumers to have their "Language of Choice"? (Check all that apply.)

English Spanish French Canadian French Other

6. Your time frame for implemention:

	Immediately		Next 90 Days
	Next 6 Months		Next 12 Months

7. How do you currently handle 1-800 consumer calls?

	At the factory or headquarters Service Bureau Other

	Days calls received (check any that apply): Mon Tues Weds Thurs Fri Sat Sun

8. Do you currently provide consumers with a "nearest" dealer look-up process on your web site? Yes No

PLEASE SEND ME INFORMATION ON THE FOLLOWING:

		FREE DealerQuik/i-DealerQuik Brochure - Please send my copy!
		DealerQuik Service Agreement - Please send a service agreement for me to review.
		i-DealerQuik Service Agreement - Please send a service agreement for me to review.
		I'd like a DealerQuik Demo - Contact me about a DealerQuik demonstration.
		I'd like an i-DealerQuik Demo - Contact me about a i-DealerQuik demonstration.


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