StimulatedYet.com - A social experiment by the private sector to better spend"stimulus"dollars

Thank you for your interest in StimulatedYet.com! If you are interested in becoming a Stimulus Provider by purchasing a banner ad on the site, please take a minute to complete the form below. This form will provide us with some preliminary information on your organization and banner ad requirements. We will be in contact with you to review this information and further discuss your requirements.

Name:
Organization:
Address:
City:
State:
Zip Code:
Existing Website Address (If any):
Phone:
Email:
Best time to reach you:
Best method to reach you:

General Business Category: (Think "Yellow Pages" Listings Category)

Annual Sales *:
Number of Employees *:

* Optional. This information will be used in the Final Report, only within combined statistics -- to illustrate growth of organizations that have participated. This information will not be divulged as specifically related to your organization

Existing Logo?:	Yes: \| No:

General Color Preferences:
If we proceed with the project, please apply Stimulus Dollars generated:	Randomly, to any business or organization awaiting funds: To a specific business or organization that is awaiting funds and is listed in the Participants Database: If you choose this option, please identify the participant below:

NOTE: Businesses and organizations receiving websites created with "Stimulus Dollars" must become paying participants in the Website Performance Analysis and Search Engine Optimization (SEO) program, thereby recycling funds back into the program and creating "Stimulus Dollars" to pay forward to others. Our goal is to help those who will help themselves and in turn help others.

NOTE: Completing this form does not commit you (the client), IXI or StimulatedYet.com to the project. A representative of StimulatedYet.com will be in contact with you to discuss the details of your project.

Additional Questions or Comments?:

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