*
Your name
*
Company name
*
Company address
*
Company city
*
Company state
*
Company zip
*
Record
type: Select the type of records you're inquiring about, you may select more than
one.
*
Purchase
frequency: Will this be a one time purchase, or would you like to receive such
records on regular basis ?
Select one
One time purchase
Regular purchase
Don't know
*
Region:
Select the area(s) you'd like to use in generating your list. List state(s),
county(s), city(s), or the first 3 digits of zip codes. We can NOT
select by "surrounding areas", "northern", "southern"
or similar requests, YOU MUST BE SPECIFIC.
*
Amount:
You may use a range such as $2,500 to $200,000, or greater than such as +$5,000, or less
than such as less than $150,000.
*
Date:
Select a range of dates, such as 6/1/99 to 12/31/99, or from a specific date to current.
*
Individual
vs. business: Are you interested in individuals only, businesses only, or both.
Select one
Businesses only
Individuals only
Businesses & individuals
Comments:
Any additional comments
*
Email address: Your
email address so we can contact you.
*
Phone number: Your phone
number including area code.
Phone number
2: An alternate number where we can contact you.
Fax number:
*
How did you hear about us
Please select one
Referral
Mail Solicitation
Phone Solicitation
Other web site link
Yahoo
Lycos
Infoseek
Excite
Altavista
Hotbot
dmoz.org
AOL
MSN
google
northernlight
Other search engines