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The Eclectic Group LLC Information Form
Thank you for visiting
www.EclecticGroupLLC.com
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Please complete this form, so that we can understand how to best help to become the "Eclectic YOU"
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First Name
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Your answer
Last Name
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Your answer
Email Address
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Phone number
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What type of services are you looking for?
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Consult: Eclectic Experts
Network: More Than Three Fifth
Travel: Eclectic Excursions
Buy: Eclectically Black
Product: Eclectic Connect
Production: MicroTales
Other:
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In as many details as possible, please explain how we can service you?
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What is your budget for this marketing effort?
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$0 to $1,000
$1,000 to $5,000
$5,000 to $10,000
$10,000 to $25,000
$25,000 to $50,000
$50,000 to $75,000
$75,000 to $100,000
$100,000 to $500,000
$500,000 to $1M
Above $1M
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