Act One Lists Order Form


Ordering Instructions

1. Fill out the order form:
Online orders - Complete the form on this page.

Offline orders - Download and print this order form and return it to us by email, fax or mail.

2. Payment Information:
Credit Card Orders:
To complete your online order, download the Credit Card Authorization form, print it and
return it to us by email, fax or mail.

Check Or Money Orders:
Please mail your payment to the address below.

Wire Transfer:
To order by wire transfer, please contact a sales representative 800-228-5478.

3. Contact Information:

Email:  info@act1lists.com

Fax:  781-639-2733

Mail:   ACT ONE LISTS
100 Cummings Center
Suite 434-J
Beverly, MA 01915-6122


Need help filling out the form? Contact us at (800) ACT-LIST (228-5478), or fill in and submit your incomplete form and an ACT ONE LISTS representative will call you with the information you need!

Ordered By:      
Name    
Title    
Organization    
Street Address    
Address (Cont.)    
City    
State/Province    
Zip/Postal Code    
Country    
Phone    
FAX
Email Address
Offer
Mail Date
Ship To: (if different than ordered by)
Name
Title
Organization
Street Address
Address (Cont.)
City
State/Province
Zip/Postal Code
Country
Phone
FAX
Email Address


*Please send a sample mailing piece or telemarketing script for all response & subscriber lists.

NAME OF LIST Order Quantity

Base Price:

Base Price - One Time Use
Base Price - One Year Unlimited Use

Additional Selections:

Category

Business Contact Name

Telephone Number

FAX Number

Employee Size

Sales Volume

Executive
Function/Title

Specialty
Function/Area

Teacher/Professor
Specialty

Primary or Secondary SIC
Code

Headquarters/Branch
Location

New Business

Demographics
(Age/Income/Gender/Etc.
)

Ethnicity

Home Address

Title Addressing

Key Coding

Carrier Route Pre-Sorting

Split Charge

Merge Charge

Bar Coding/Bag Tags

Other Selections

Geographical Selections:

Entire U.S.

Nth Select

Pick a State

Pick a Province

SCFs

Zip/Postal Codes

Counties

Formats:

Cheshire Labels
Pressure Sensitive Labels
Magnetic Tape/Cartridge
Disk IBM 3.5"
CD Rom
Sheet Listing
3 X 5 Index Cards
E-Mail Transfer
Modem Transfer

Shipping/Handling:

Standard 2-Day Delivery Minimum
Overnight Delivery Minimum
Payment Method:
 
Company Purchase Order #
(does not apply for credit card orders)
Please note: Payment terms are net 30 days from the invoice date to customers with a continuing use of our services.  Prepayment deposit may be required on any order and is always required on the first three (3) orders from new clients.  Accounts may be opened upon approval by our credit department.   Business or personal checks, money orders, as well as MasterCard, Visa, American Express, and Discover credit cards, are accepted.

      


Having trouble filling out the form?  
Contact us at (800)ACT-LIST (228-5478), or fill in and submit your incomplete form and an ACT ONE LISTS representative will call you with the information you need!