Please take a moment to complete and forward the following short questionnaire. It takes just a few minutes, but provides the valuable information we need to meet your needs.

Please complete the form and click the Send button below. (Items marked with are required)
	Name
	Title
	Company
	Address
	City
	Province Country Postal Code
	Telephone   Fax
	Email
	How did you hear about us? Internet Search Google AdWords (PPC) Referral Twitter Other
1.	Are you:     President     Vice-President of Sales or Marketing     Director of Sales or Marketing     Other:
2.	Your advertising program includes: Business to Business Not for profit Corporate Communications Government Retail      Consumer        Other:
3.	The majority of your spending is on? Marketing directed at prospects Marketing directed at existing customers
4.	You track results and can identify what marketing programs deliver the best return on investment.     Yes No
5.	You work within a business category that is: Emerging Growing Mature
6.	Your business category has: Some competitors Many competitors None (because you are creating a new category)
7.	Within your business category: Most buyers are men 50/50 Most buyers are women Don't know
8.	The majority of your existing sales are generated from referrals and/or individuals and companies who you, or your employees, know personally.     Yes No
9.	What is your product or feature:
10.	What is the unique selling point for your product or feature:
11.	Do you have a marketing plan:     Yes No
12.	Do you have an advertising plan and budget:     Yes No
13.	Your advertising budget is:   Under $500 $10,000 - $20,000 $500 - $1000 $20,000 - $50,000 $1,000 - $5,000 Above $50,000 $5,000 - $10,000
14.	In terms of advertising spending, how would you rank in the industry:     1st 2nd     3rd Lower
15.	Your advertising program includes: Print advertising Direct mail Radio and/or TV Trade Shows The Web Point-of-purchase Outdoor Other:
16.	Do you sell on:     Value Price Both
17.	Is your brand well known in the marketplace:     Yes No
18.	In recent years, your advertising has:     Increased     Decreased
19.	You have: Sales reps Authorized dealers Retail outlets
20.	Do you analyze the advertising of your prime competitors:     Yes No
21.	Can you define the marketing strategy of your prime competitor:     Yes No
22.	Have you ever retained an advertising agency or consultant:     Yes No
23.	How many employees do you have? 1-4 5-20 21-50 51-100 101-150 More than 150
	Comments:

Words at Work Advertising & Marketing Inc.
19 Lockridge Avenue, Unionville, Ontario, Canada  L3R 7S6
Telephone: 905-940-6610     Toll-Free Outside Toronto: 1-877-940-6610