Dealer Order Form

Dealership Marketing Materials Information

Dealership Name (please input EXACT Dealership Name)

Website

Phone Number

Street

City

State

Zip Code

Sender "From" Name (if different than Dealership Name provided)

Please Enter AdPoint ID

Dealership Contacts for Distribution Lists

	First Name	Last Name	Title	Email	Phone Number
Dealership Contact					12 characters left.
Dealership Contact					12 characters left.

If you have additional Dealership Contacts, please email LocaliQCCChanges@clientcommand.com with the same fields listed above

Campaign Information

Expected Start Date

Please fill the date in MM/DD/YYYY format

Select Number of Sales Records

Are you also purchasing Conquest Email?

YesNo

Do you need DMS Integration?

YesNo

Please Select if you would like to add Smart Retention Email sends (Active Shopper DB only up to 5k per month))

YesNo

Are you also purchasing Service Records?

Yes with Sales CampaignYes, as a Standalone ProductNo

Select Service Audience Records

Please Note DMS integration is required for Smart Retention and/or Service

Targeted Market

What radius was presented in the Sales Process?

Target Zip Code

Comments Regarding Target Zip Code

*Radius will be measured from Dealership's zip code in details above unless otherwise noted in the Target Market.

Monthly Sales Average (New + Used)

DMS Information

DMS

Reynolds & Reynolds Information

Customer #

Store #

Branch #

DMS Other

Dealership DMS Contact (for DMS Assistance)

First Name

Last Name

Phone Number

Co-Op Contact/Identification Information

First Name

Last Name

Phone Number

Federal Tax ID #

OEM Dealer Code

LocaliQ Info

	First Name	Phone Number
Account Executive		12 characters left.
Sales Manager		12 characters left.
Client Success Manager		12 characters left.
Auto Implementation Team	autoimplementation@localiq.com

LocaliQ Internal Information

Adpoint ID Number

Order ID Number

If you receive an error message from a field that requires an email address, please make sure to remove any spaces before or after the email address.

Contact Information