Partners Submission

Company Brand Details

To help us get a better understanding for your brand, please fill out the form below as much as possible. We look forward to working with you on this new venture!

Client Company Name *

Campaign Point of Contact *

First

Last

Client Mobile Number *

Client E-Mail *

Client Website *

Recommended Company Logos

Click or drag files to this area to upload. You can upload up to 10 files.

Client Brand Details

Brand Colors (Hex Code #'s if available)

Client Tagline

If Available

Client Mission Statement

Goal for DigiRu Digital Marketing *

Photos

Click or drag files to this area to upload. You can upload up to 20 files.

Please upload any photos you would like to include on your landing page as well as Digital Advertisements.

Preferred Zip Codes to Target

Target Audience Demographics, Interests, Keywords

Who Should Receive Leads? *

First

Last

E-Mail Address for Leads *

CRM

Complete this if you have a CRM you would like to automate your leads into.

Mobile Number For Leads

Desired Campaign Length

3 Month Minumum (Recommended)

Past Successful Marketing Tactics or Campaigns

Preferred Southeast Mortgage Loan Originator

If applicable

Additional Information

Save and Resume Later