Please note: We reserve the right to submit all Fraudulent Orders and those orders that result in chargebacks without first trying to resolve the issue through our offices, to an industry related blacklist database accessed by over 200 advertising providers. The information stored within this database is a type of credit rating system that warns other networks of negative actions. If your company appears in this database, you may have trouble purchasing any further advertising products for your business.


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1. Email Address * 2. Your Name * 3. Your Phone Number * 4. Website address to promote * 5. Target channel for your website * Business Opportunity Education Health Computers Travel Cars Gambling Lifestyle Finance Telecom Website Promotion Jobs Misc Entertainment Home Shopping Adult To select more than 1 channel, hold down the Ctrl button on your keyboard while selecting the channels. 6. Which country do you want your website to be shown in? * USA UK Canada Australia Indonesia Worldwide Other If other, please list the country in the Comments box. To select more than 1 country, hold down the Ctrl button on your keyboard while selecting the countries. 7. Would you like us to come up with a keyword and competitor url list for you? (They will be sent to you for approval before your advertising campaign starts. Please allow up to 1 business day) * Please choose one Yes No If no, please fill out the keyword and/or url boxes below 8. Please list as many keywords that describe your website Please enter one keyword per line. 9. Please list as many competitor urls that your potential customers may visit Please enter one competitor website url per line. 10. Enter the City where you are currently placing the order from * To prevent fraudulent orders, we verify the city your order was placed in with the credit card company's database 11. Enter the State where you are currently placing the order from * To prevent fraudulent orders, we verify the state your order was placed in with the credit card company's database 12. 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    Referred by Gerard School or Studio2000    Referred by Julian Angel - Bellamoon Accessories    Referred by Christopher Plant    Contacted by a Sales Associate    Referred by John ORyan - TrafficMan.us    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    13. If your advertising campaign comes with a Free Email Campaign, please enter your email subject title (up to 3) and email ad here. 14. Would you like to advertise your website 24 hours a day? * Yes No If no, please enter start time and stop time in the comments box. For example 7am Central Time to 5pm Central Time Comments or coupon code