EXTREME MARKETING MAKEOVER

Small Business Edition

Application

Sponsored by
Heavy Guerrilla - Revolutionary, Affordable Marketing to Grow Your Business.

Azure Summers - Graphic Design

Pardiman Productions - Video Production and Web Design

Bondarook & Associates - Premium PR. High-Octane Results.

ALL INFORMATION IS HELD IN STRICT CONFIDENCE. YOUR INFORMATION WILL NOT BE SOLD.

Winner Announced: September 9th, 2009

GENERAL COMPANY INFORMATION

* Company Name

* Address

* City

* State

* Zip

* Company Phone

Company Website Address

OWNER INFORMATION

* Applicant's Name

Email Address

* Owner, Primary Shareholder, or Manager's Name

Owner, Primary Shareholder, or Manager's email

* Owner, Primary Shareholder, or Manager's direct telephone

COMPANY BACKGROUND

* How many years has your company been in business?

* What is your primary product or service?

* Please describe what kind of volunteer work or community service your company has been involved in.

* Please describe your company's proudest achievements.

* Please summarize your company's CURRENT financial situation and how it affects you and your employees. What makes you deserving? What makes your situation unique?

* Why does your company need a marketing makeover? What are the top 5 issues that need attention?

* How many employees do you have?

* What was your total sales in 2006?

* What was your total sales in 2007?

* What was your total sales in 2008?

* What is your business structure?

* Do you currently have a formal, written marketing plan?

NO

YES

PLEASE MAKE SELECTION BEFORE SUBMITTING

* If selected to receive the Extreme Marketing Makeover, you and those associate with your company may be filmed, videotaped, and photographed, and your name, image and likeness may be used in or to publicize this event. In addition, a snap-shot of your company...will be created with fundamental metrics such as sales, lead counts, etc. that we will be posting on our website. By clicking on "AGREE" you waive any rights of privacy or publicity in connection with this production and certify that all information stated on this Application is true.

DISAGREE

AGREE

* Indicates Response Required