Project 7148 Demographics Form Project 7148 Demographics Form First NameLast NameEmail Address *Please enter an email addressPlease enter a backup email addressVery highly recommended-used once to send commencement emailPhone NumberClick Through WebsiteEnter the website you would like someone to visit when they click your adPlease describe in detail the type of customer you are looking to attract0 / 180Enter the City (cities) or zip codes of where you would like the Ad to be available for playPlease enter cities first, and only enter zip codes if they are specific parts of a city0 / 180Target Gender *Please select an optionAllMaleFemaleYearly Household Income *Please select an optionAllOver 250K100K-250K50K-100KUnder 100KHow many times would you like the SAME VIEWER to view your ad *Please select an optionOnce2 times5 times10 timesUnlimited amount of timesThis control is if you want all new viewers, or would like the same viewer to see your ad a specific amount of timesTarget by Marital Status and Children *Does Not Matter (all)Married with childrenMarried no childrenDivorcedUnmarriedDevice Type * If you wouldAll DevicesMobile only5 times10 timesUnlimited amount of timesThis control is if you only want specific devices to see your advertWhen would you like your project video to start? *Please select an optionAs soon as possible after my NEW or REVISED project video is approved by mA specific date (please provide below)Specific start dateSKIP THIS IF YOU SELECTED "AS SOON AS POSSIBLE" ABOVEI understand and agree with all terms and conditions of this project agreement *Please select an optionYESNORepresentative of Company Full Name *Position with company *HTMLFull project TermsSubmit Demographics informationPlease do not fill in this field.