Test web form

Marketing question in Checkout

  • Please choose from the following:
    Radio: specify station/D.J.'s name
    Catalog: priority code number (from back of catalog in light blue rectangle)
    Email: specify sender or type code
    TV: specify program or network
    Magazine Advertisement: please specify
    Search Engine: (google, Yahoo, AOL... etc.) & what you searched for
    Internet: specify website
    Other: please specify

* Required Fields