Data Card Request Form

This is the form to use to request a data card on any mailing list. Data cards include the characteristics of lists, such as the quantity and source of the list(s), along with the rental cost, selects, average order size, restrictions, minimum order requirements, list formats, etc.

The requested data card(s) will be sent to you as soon as possible by e-mail. (Most requests for specific datacards are processed immediately.)

Which datacard(s) do you want us to send to you?

ALL ITEMS		SELECTED ITEMS

Please provide us with the following information:

First name
Last name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
FAX
E-mail
URL

Telephone:
641-472-2332

FAX: 641-472-5729

Address:
508 N. Second St.
Suite #203
Fairfield, IA 52556