Date:
Requester:
Requester Phone #:
Requester EMail Address:
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| Heading Requested:
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Request Type:
New
Change
Delete
Cross Reference
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| Directory Name:
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Heading Requested for:
Upcoming Issue
Next Issue
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| Other Information
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Business Name:
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| Telephone Number:
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Primary Heading Currently Used:
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1.) Why would the new heading be more beneficial to the advertiser than the one currently being utilized?
(Explain)
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2.) Will the new heading cause heading jumping?
Yes
No
3.) Is the terminology well known to:
User(Consumers)
Industry
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4.) Is the requested product or service used
by:
Consumers?
Businesses?
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5.) Describe product or service: (How is it
used?)
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6.) Is this a New Business, Product, Service,
etc?
Yes
No
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7.) Is this heading restricted by legal, or
professional associations? Other? If so, explain.
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8.)
If there is a National Association relating to the requested product/service, please list the name.
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9.) Suggested related headings:
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10.) Suggested cross references:
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11.) What heading(s) are being used in competative\surrounding directories?
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12.) What item of advertising does your customer plan to place at the requested heading?
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