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1. Your E-mail *
2. Your Name *
3. Your Phone Number *
4. Your Lead Capture page * This is the page with a form asking people to enter their email address. If you do not have one, enter please use the TrafficExcess default page
5. Your Website Sales page * This is the page a person that opts in sees, after he/she has filled the form. It has a link to your Join or Order page
6. Country to target * Note: To choose more than one country, please hold down the Ctrl button on your keyboard while selecting the countries.
7. Login information to your home business back office or Autoresponder such as Aweber or Getresponse To know which signups have come in from our advertising efforts. To not provide access, please put No login info
8. How did you find us? * Clicked on banner ad (please specify where in your comments)   
Ads by iTotalFind   
Yahoo   
Email Advertisement   
Bing   
Ordered from Search Engine Ad: http://www.trafficexcess.com/Traffic.html   
7Search   
Referred by Julian Angel - Bellamoon Accessories   
Clicked on Creative Ad: http://www.trafficexcess.com/trafficadyes.html   
Contacted by a Sales Associate   
Clicked on Creative Ad: http://www.trafficexcess.com/temail.html   
Google   
Recommended by a Friend   
I have ordered advertising from Traffic Excess before   
If Other, please tell us where you found TrafficExcess.com in your comments   
9. Comments or coupon code