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CUSTOMER MEDIA SUBMISSION REQUEST FORM

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Please use this media submission form for custom posts, ads or print media requests. If you have questions about the process or your submission, please email mediasubmissions@innovatesocialmedia.com or contact your customer account representative. 

Thank you.

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Name *

First

Last

Email *

Phone Number *

Company Name *

Address (If Shipping Item To)

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Date and Time of Request: *

Date

Time

PROOF IS REQUESTED

• Yes
• No

CAMPAIGN SUBMISSION PROCESS

Please complete all fields for proper processing of your request.

Type of Campaign (Applicable Charges Will Apply)

• Custom Print Ad
• Custom Social Media Post
• Social Media Ad
• Email Blast
• Custom QR Code w/Tracking

Campaign Title *

Custom QR Code Scan Destination URL

What webage you want the QR code to land.

Campaign Start From Date: *

Date

Time

The start date of your campaign

Campaign End Date

Date

Time

Date and Time You Want Campaign to End

Content for Ad or Social Media Post *

Call to Action Button Text (Submit, Click Here, Get It Now, etc.)

What action do you want the customer to take?

Call to Action Button Link URL

Have call to action button render to this URL (webpage) – Where you want the customer to go when they click the link.

Paid Advertising Budget

Amount you wish to spend on this campaign. (This will be billed back to your on file form of payment.)

Image Upload OR Bigstock Image Number

Click or drag a file to this area to upload.

Upload the image you wish to use in this campaign. Must be at least 300 dpi. Larger images may require a higher resolution. Images must be original and owned by the customer or selected from BIGSTOCK, a license and royalty free image stock provider.

Bigstock Image Number https://www.bigstockphoto.com/

Select a photo from this website and input the stock photo ID here.

Comments or Notes

Design RUSH Charges

• 2 Day Turnaround – $75.00
• 5 Day Turnaround – $50.00

Processing

You will receive a confirmation email upon submission of this form. Your account representative will contact you within 24 business hours from the mediasubmissions@innovatesocialmedia.com email address with questions or requests for information. Please whitelist this email address to keep it from landing in your SPAM or Other folder.

Submit

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