Name of Company:

Campaign Name:

Contact:

Tel Nos:

Address:

Country:

Fax No:

E-mail Addy:

Please Indicate What Period Of Time You Would Like Your Campaign To Run:

What Category Of Products Do You Represent?

Who is Your Target:

Primary:

Age Group

Income Level:

Lifestyle Profile:

Secondary:

Age Group

Income Level:

Lifestyle Profile:

Would You Like To List The Main Brand/s? (Optional). Please List Below.

Do You Have An Advertising Agency Or Agencies? Yes: No:

What Objectives Are You Specifically Trying To Achieve From Your Campaign? Please List Below.

A:

B:

C:

What Markets Are You Interested In Advertising In? (Please Tick All That Apply)

Anguilla

Aruba

Barbados

Belize

British Virgin Islands

Curacao

Grenada

Jamaica

St. Lucia

St. Vincent & The Granadines

Turks & Caicos (Bvi)

Antigua & Bermuda

Bahamas

Bermuda

Bonaire

Cayman Islands

Dominica

Guyana

St. Kitts Nevis

St. Maarten/ St. Martin

Trinidad & Tobago

Usvi - St. Thomas, St. Croix

Do You Need Some Advice On What Possibilities Exists For You Before You Determine What You Can Invest In Advertising ? Yes: No:

Other Requests ?

Do You Have A Budget (US$) Already Set For This Campaign ? Yes: No:

How Would You Like To Split The Total Campaign Budget By Market ?

Please Indicate Below Expressing The Amount To Proportion By Either $$ Or By A Percentage

MARKET BUDGET US$ PERCENTAGE OF TOTAL Anguilla Antigua & Bermuda Aruba Bahamas Barbados Bermuda Belize Bonaire British Virgin Islands Cayman Islands Curacao Dominica Grenada Guyana Jamaica St. Kitts Nevis St. Lucia St. Maarten/St. Martin St. Vicent & The Granadines Trinidad & Tobago Turks & Calcos (BVI) Usvi - St. Thomas, St. Croix

Do You Have Creative Materials Already?

If Yes, Please Indicate The Size Or Lengths

TV - Seconds Press - (Inches / Cm) Radio - Seconds Magazine- (Inches / Cm) (bleed Size/Non Bleed) Web Ad - (Inches / Cm)

We look forward to receiving your response to the above.

If you do not know where to start with answering the above questions you can call us on: 1 (868) 623-1711 Extension: 3390 for Rachel and 3385 for Carlene and we will walk you through the process.