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Carrier Identification Form

If you are a fleet owner/operator and qualify, Mobile Ad Group will pay you to use your vehicles for advertising. After an overall assessment is done to your vehicles, we will install a framing system or adhesive vinyl onto the vehicles at no disruption to your operations. You will then get a monthly payment whenever there is an ad on your truck. SIMPLE.

Please fill out the following questionnaire and a representative will contact you.
* - required field

Contact Information
*Company:		Industry:
*Name:		Title:
*Phone:		Fax:
*Address:		*Email:
*City:	ZIP:

Vehicle Survey:

Size of Trucks (Check All that Apply)
	12'- 16'	Quantity	Coverage Area
	18' - 24'	Quantity	Coverage Area
	26' - 28'	Quantity	Coverage Area
	30' - 53'	Quantity	Coverage Area
	Vans	Quantity	Coverage Area
	Other	Quantity	Coverage Area

Overall condition of the vehicles:

Excellent

Good

Fair

Poor

Any existing framing system, vinyl, decals or paint on the vehicles?

	Yes
	No

If Yes, please describe the type and location on on the vehicle.

Do these vehicles park overnight at the above address?

	Yes
	No

If No, provide address

Do you have GPS installed in your vehicles?

	Yes
	No

If Yes, name of provider

Have you ever participated in TruckSide Advertising?

	Yes
	No

If Yes, name of company

Do you have an indoor facility that fits your vehicles?

	Yes
	No

Comments:

I would like to receive more information regarding industry news and company promotions

How did you hear about us?

Newspaper

Email Message

Television

Search Engine

Radio

Other Internet Source

Magazine

Saw a Mobile Ad Group Vehicle

Trade Publication

Referral

Please Explain:


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