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We'd like to thank you for working with Premium Network. We need to gather detailed traffic and audience demographic information for all of our web sites. This information will allow us to tell advertisers about your inventory, and will assist us greatly when considering placement for new orders.

Company Name:
Site URLs (Seperate with Commas):

Update your contact information:

Contact Name:
Phone:
Fax:
E-mail:

Please fill out all relevant information on your site:

Target Audience:
Monthly ad impressions:
Monthly unique visitors:
Monthly page views:

Please check the pricing models your site uses, and supply us with the rate card information for each pricing model. Note: Enter a range of CPM and CPC rates you will accept.

Yes	No	Creative Sizes	CPM Rate	CPC Rate
		Banners and Buttons
		468 X 60 (Full Banner)
		234 X 60 (Half Banner)
		38 X 31 (Micro Bar)
		120 X 90 (Button 1)
		120 X 60 (Button 2)
		125 X 125 (Square Button)
		728 X 90 (Full Banner)
		Rectangles/Islands
		300 X 250 (Medium Rectangle)
		250 X 250 (Square Pop-Up)
		240 X 400 (Vertical Rectangle)
		336 X 280 (Large Rectangle)
		468 X 60 (Rectangle)
		Skyscrapers
		160 X 600 (Full Banner)
		120 X 600 (Full Banner)
		120 X 240 (Full Banner)
		Other Inventory
		Pop-Up
		Pop Under
		Transitional
		Text Links
		Other
		Other
		Other

Would you consider CPA?....  Yes  No Targeting capability: (geo, demographic, time, age, content, etc.)

Please check the type of advertising creative your site accepts.

Yes	No	Types of Creative Advertising
		Audio
		Bluestreak
		DHTML
		Emblaze
		Enliven
		Eyeblaster
		Flash
		HTML
		Iframes
		Interstitials
		Java
		Microsites (will you host a microsite?)
		PointRoll
		Shockwave
		Shoshkeles
		Sponsorship
		Streaming Ads
		Unicast
		Other:
		Other:
		Integrated Content (redesign of site interface to include advertisers key art on home page and main sections of website)

E-mail and Newsletter Lists

Yes	No	E-mail List	# of E-mails	CPM Rate	CPC Rate
		Stand Alone
		Newsletter

Stand Alone email:

Double opt-in?	Yes  No
User Selects/Targeting Capabilities

Newsletter List:

Double opt-in?	Yes  No
User Selects/Targeting Capabilities

Do you do Co-Registration?

Yes	No	Co-Reg	Rate	How many monthly	Double Opt-In
		Opt-In			Yes
		Opt-Out			Yes

Notes:

Premium Network

San Francisco
Premium Network, Inc.
1001 Bayhill Drive, 2nd Floor
San Bruno, California 94066

Phone: 415-575-1444

Fax: 501-642-6376

For more information on:
• Web site representation, click here
• Advertising on the Premium Network, click here