Cutomer Lead Form
1. May I get your First and Last Name?
2. What is the best email address for you?
3. Are you advertising a Service, Product or an Event?
What is the name of your event?
What is the Date of your event?
4. Can you tell me what store/location you saw one of our advertising screen?
Golden Krust (Austell)
Golden Krust (Conyers)
Golden Krust (Douglasville)
Golden Krust (Fairburn Commons)
Golden Krust (Hiram)
Golden Krust (Kennesaw)
Golden Krust (Lawrenceville)
Golden Krust (Marietta)
Golden Krust (Morrow)
Golden Krust (Old National hwy)
Golden Krust (Snellville)
Golden Krust (Stone Crest)
Golden Krust (Stone Mountain)
Fireside (Lithonia/Covington hwy)
Irie Mon Cafe (Peachtree St, Atlanta)
Jamaica Mi Krazy (Smyrna)
Jamrock (Atlanta/Metropolitan pkwy)
Kool Runnings (Norcross)
Mangos (Auburn Ave)
Sevananda (Moreland Ave. Atlanta)
Sunshine Restaurant (stone mountain)
US1 Package (Decatur)
5. What Industry is your business in?
6. Do you have an AD you would like to use? or do you need us to design one for you?
I have my own AD I want to use.
I would like your company to design our AD
Please list the industry the customers business is in
7. When do you want to start advertising?
Customers phone # (write down the phone # from your incoming call list)
This field is for validation purposes and should be left unchanged.
Select a Plan
Basic AD Plan
Premium AD Plan
Enterprise AD Plan