Business Name:

Contact Name:

Phone:

Fax:

E-Mail:

Website:

Business Address:

City:

State:

Zip Code:

Years in business:

Please describe your category of business: Apparel Author or Publisher Automotive Beauty Footwear Handbags Health Jewelery Media Technology

Include a brief description of your merchandise:

What is the price point of your merchandise:

Do you sell merchandise at any other events? Yes No

If "Yes", which ones:

How do customers normaly purchase your merchandise?

How did you find out about the Shopping Party/Milla by Mail?

Would you be interested in additional marketing opportunities? Yes No

If so, which one(s) Logo placement Magazine ads Newspaper ads Press mentions Radio Website links/banners

Please describe your target customer:

How are you currently promoting your company/products?

Would you be interested in participating in other Milla by Mail events? Yes No

If "Yes", what size (select all that apply):

50-100 people 51-250 people 251-500 people 500-700 people 100 and over

Would you be interested in participating in events in other cities? Yes No

If so, which one(s):

Would you like to contribute an item to the gift bag? Yes No

If so, describe the item:

Comments/Questions