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Name: Company:	Email: Phone (area code first):
BE SURE to include your contact information so we’ll be able to send you the results!
CAMPAIGN NAME For example: Summer Catalog, Regional Email Broadcast, Tour Brochure, etc.	CAMPAIGN TYPE Direct Mail Email Broadcast Direct Mail/Email Combination
a. TYPE OF DIRECTOR — select all that apply Concert Band Jazz Band Marching Band Orchestra Choir Drama DISTRICT SUPERVISOR OPTION: Add DS to above selection DS only - no teachers	Classroom Dance Guitar General Music Music Department Chair Keyboard Music Theory
b. TYPE OF SCHOOL — select all that apply   [PLEASE NOTE: The choices below are each a specific type of school.]
K-12: K-12: Schools with 12/13 Grades K-6: Elementary K-8: Elementary and Jr. High Grades	6-8/7-9: Middle School and Jr. High Grades only 6-12/7-12: Combination Jr./Sr. High Schools 9-12/10-12: Sr. High Schools
c. ENROLLMENT All Greater than 100 students Greater than 200 students Greater than 300 students Greater than 400 students Greater than 500 students Greater than 750 students Greater than 1,000 students Greater than 1,500 students Greater than 2,500 students Other-use description field below Other Enrollment details:
d. GEOGRAPHIC LOCATION Do you wish to include/exclude (please indicate which below) certain recipients by: State Radius (for example, within 100 miles of a given address) ZIP Code(s)
e. WEALTH (median income of community surrounding school) MTD breaks our schools into percentiles by 10%, designated from 1-10 below.
1 - Top 10% 2 - Top 20% 3 - Top 30% 4 - Top 40% 5 - Top 50%	6 - Top 60% 7 - Top 70% 8 - Top 80% 9 - Top 90% 10 - All
f. QUANTITY Do you wish to limit the total number of names/addresses to a certain amount? (Explain below):
g. LICENSE TYPE One-time use (1x) Two-time use (2x)	Three-time use (3x) Unlimited use for 1 year
Any other criteria or special instructions?
We do have other selection parameters. Please contact us for further refinement.