Advertising User Information

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Please fill out this form, taking care to use the format listed in each of the section descriptions
This information will be used not only to build your user profile in Denim Social, but to create ads and landing pages on your behalf. Please ensure the information is accurate and up to date.

First Name (This is how it will show up in our system and on your landing page, if applicable) *

Last Name (This is how it will show up in our system and on your landing page, if applicable) *

Email Address (make sure you have access to this email, it is where set up details & leads will be sent) *

Facebook Page URL (Example: 'www.facebook.com/denimsocial'. To find your URL, simply go to your facebook profile and copy the address in the search bar. We will use this URL to request advertising access to your page) *

Where do you want to direct your audience when they click on your ad? Please enter the URL below (Example: 'www.samplebank.com/AmyLowell'. This is the link that the audience would be taken to when they click the ad. If you have an existing landing page, this is where you can add it. This can be updated later)

Where do you want to Advertise? Please enter the zip code in which you would like to advertise. (Example: '57483'. Please only enter one existing zip code. The system will use this zip code center point to determine the area in which it will advertise) *

Mobile Phone Number (Example: '555-555-5555')

Office Phone Number (Example: '555-555-5555')

Address 1

Address 2

City

State (Example: 'MO')

Zip Code

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