Smart Ad Network- Merchant and Advertiser Registration
(For Advertiser, only fill the * section)
Advertiser Information
Contact Name:
Business Name:
Address:
Tel:
Cell Phone:
Fax:
Email:
Business Type
(SIC code if known):
Web Page:
General Information
Best way to contact you:
Email
Phone
Fax
Can you get web access to approve ads?
Yes
No
Please describe your target audience
(loyalty,age,income range,etc.)
Do you work with an outside Ad agency?
Yes
No
Ad agency name
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