Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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Are you a...?

Vendor

Mailer

Other

Are you part of a non-profit organization?

Yes

No

Are you a member of any other mailing organizations?

MMA

MSMA

DMA

MDMA

AD Fed

Other

What Classes of mail do you typically send?

First-Class

Priority

Express

Standard

Periodical

Parcel Post

Parcel Select

Media

Library

Bound Printed Matter

What types of mail do you typically send?

Postcards

Letters

Flats

Packages / Parcels

Other