INQUIRY FORM

WHATEVER TYPE OF MARKETING OUTREACH YOU USE, 1-800-DIVORCE SUPERCHARGES THE RETURNS ON YOUR ADVERTISING INVESTMENT.

BE SURE TO CLINCH 1-800-DIVORCE EXCLUSIVITY FOR YOUR ENTIRE RADIO AND TV MARKET.

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Your name:
I request (check as many as you want):	voice contact at the phone number below
	no-obligation quote for my market area e-mailed to the e-mail address below (please specify your city and state below)
	no-obligation draft Service Agreement e-mailed as an attachment to the e-mail address below (please specify your city and state below)
Your phone number:	(___)___-____
Your e-mail address:
Your city or town:
Your state :
Your current level of interest in 1-800-DIVORCE (check one only) (optional):	just cruising
	some interest, but dubious
	interested - let's see the cost and terms
	very interested, subject to cost and terms
	holy cow!-give me a FREE 48 hour option on my market area
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