ExactTarget Order Form

Required Field Required fields:

Contact Information
















 

 

Select ExactTarget Services

Everything below, is a agency requirement. So the agencies that wants the additional information when invoiced will supply it.



Initial term Renewal term Upsell


Package Selection:

 
Email Selection

Pay-as-you-go Email

Bulk Email Purchase

# of Emails

per email rate

 

Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
Feature / Service ExactTarget SKU Annual Price
Comments
 
Agency Billing Information














 

Special Billing Instructions (If Any):

(if required):

If using project the following are required:




Other codes that may be required by agency:










Other Information


Required Field