Thank you for visiting our Web site. Please complete this form, then click the "Submit to MDS" button at the end. IMPORTANT: You must complete all entries in the name and address boxes.

WHERE DID YOU HEAR ABOUT US?  
 

SEND ME INFORMATION ABOUT YOUR SERVICES (to save time, visit our website after you submit this form):
         Yes
         No

For more immediate assistance, call us toll free in the U.S. at 800-MDS-DATA (in New York City, 212-279-4800) or contact our Service Center in your area.

CHECK THE COMMUNICATIONS ORGANIZATIONS WHICH YOU BELONG TO:

Association for Women in Communications National Association of Government Communicators
Black Public Relations Society National Investor Relations Institute
Council of Public Relations Firms Public Affairs Council
Hispanic Marketing and Communications Association Public Relations Society of America
International Association of Business Communicators
 Women Executives in Public Relations
Other Organization

ADD ME TO YOUR LISTS FOR A FREE COPY OF YOUR ANNUAL "POCKET MEDIA GUIDE." Available to U.S.-based PR practitioners only, the PMG is published annually at end of year. Designed to fit easily into a wallet, the palm-size guide includes names and addresses, with phone numbers, of more than 700 major print and broadcast media in North America, plus a calender, annual media statistics, and a publicity primer.
         Yes
         No

Additional copies delivered to a single U.S. address are $1.50 each, payable in advance by check or credit card. Checks should be addressed to MDS, Dept. P, 307 West 36th Street, New York, NY 10018-6496. For credit card purchases, we will need the following information: 1) type of card (e.g., Visa or AmEx), 2) name of organization and/or person on the card, 3) card number, and 4) card expiration date. You may mail credit card orders or you may use the COMMENTS field below by entering the required information.

 
NAME AND ADDRESS (All entries are required to process your request)
 
Name:
Title:
Company:
Street Address:
City:
State:
Zip:
Telephone: (numbers only with no spaces. example: 5554443333)
Fax: (numbers only with no spaces. example: 5554443333)
EMail Address:
Website Address:

 

 

COMMENTS