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Change Order Form

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Order Reference Number *

Reason for Change *

Your Name (First and Last) *

Your Email Address *

Publication Name *

Partner Name

Publication Type

Weekly

Daily

OtherOther

Billing Adress

Publication Date

Creative Assistance

Creative Assistance $50

No Assistance Needed

Updated Deployment Quantity *

Number of Recipients Desired

From Line

Seen by subscribers as sender

Subject Line

Seed List

One Email address per line, up to 6 maximum. These people will receive the test and campaign

Clickthrough Link

For Multiple clickthroughs use the additional notes field.

Geographic Target Area

Metro Area, Zipcodes, Town Names, Etc.

Social Media Headline

25 Characters Maximum

Social Media Message

90 Characters Maximum

Updated Start Date *

End Date

Additional Instructions/Notes:

Terms & Conditions *

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