Please fill out this form completely and click the SUBMIT button at the bottom of the form. We will review your order and contact you to confirm your selections and mailing list criteria.  If you have any questions call 1-877-823-7813.

"*" denotes the field is Required



SCI Sales Agent:     SCI Account Manager:     (Leave blank if first order)

  *         *   

      * Contact:  

  *     FMO/Parent Company:

  *       *       *       *    

  *   Fax:     *

Contact Preference:     (For sending proofs approvals, zip counts, etc.)


  * Mailer Type:   Extra Options:  

* Please see pricing to determine how these extra options affect your pricing.

Seminar Title:


  * Where shall the text of the card come from?

     CA Lic#:  

(Please avoid hotels, country clubs, and lower-end restaurants –
our experience is that these locations usually produce poor responses)

Restaurant #1 Name:     Address: 
City:    State:    Zip:    Phone:   

Restaurant #2 Name:     Address: 
City:    State:    Zip:    Phone:   

     (SAMPLE)Overflow Dates?
Restaurant Smith's Burgers
Day of Week Wednesday
Seminar Date    01/04/11  
Lunch/Dinner Dinner
Seating Capacity50
Start Time            4:30 PM     

If using multiple restaurants/dates, please provide information on a separate email.
Note: All mailers will use the Agent's return address.


Option 1: $135.00
Option 2: $210.00
Option 3: No Reservation Line Setup Needed – Using own RSVP Phone#:     
  Yes, please gather callers meal selections at time of reservation (please list below):  



(Please see page 1 for instructions on how to determine the total amount to mail)



  *       (Recommended-54+)      (Recommended-ALL INCOMES)

*(Note: Using an income filter such as $20K and up eliminates customers with high assets but low income, e.g. widows)


 - ( Single Family Dwelling Unit-increases probability of being a homeowner. Recommend using 5 years+ at same dwelling.)

 add $0.015 to price per piece

 add $0.02 to price per piece

 add $0.02 to price per piece

 add $0.02 to price per piece

Eliminate the following:   (Remember, many people own apartments and condos)


Zip Codes:  Pull names from these zip codes:

  *   8th zip code:
2nd zip code: 9th zip code:
3rd zip code: 10th zip code:
4th zip code: 11th zip code:
5th zip code: 12th zip code:
6th zip code: 13th zip code:
7th zip code: 14th zip code:
  *  Which order shall we pull addresses from the zip codes above?


Payment Method:

NOTE: When selecting a payment method with this indicator (*) Subtract 1¢ Per Piece

Please do NOT send payment until you receive your invoice from

  * Send Invoice to:          Email Address:  

Special Instructions: If there are any special requests, instructions or questions you would like to add, please use the form below. We will contact you with the answers.  

Read before agreeing below:

I agree to not duplicate this Mailing Program in any manner, as it is protected under intellectual property rights © Seminar Crowds, Inc. (SCI), 2015. I authorize SCI to print my invitations and submit them within 1-2 business days of my estimated mail date to the USPS for delivery. I acknowledge and agree that SCI does not guarantee response rates, results, or delivery by the USPS. I will not hold SCI liable for mail which is delayed due my lack of payment, my lack of written approvals, or the inability of the USPS to deliver the mail for any reason including weather related delays. We suggest you add extra time to your mail date during the winter months. The mailing lists utilized by SCI are acquired from third parties that used their best efforts to meet your selected criteria. No assurance can be given that the list used for your mailing will be completely accurate. Certain selects use modeled data which is different from self-reported data, therefore full accuracy cannot be assured. We make every attempt to successfully remove households that you request to delete from your mailing. This service is provided at no charge to you, our valued customer. However, this service is not perfect and we do our best from our side. Seminar Crowds, Inc. is not responsible for individuals who may receive your invitation even though you asked for them to be removed.

Laws governing the content of advertising material including your invitation vary from state to state. Also if you are affiliated with a FINRA member firm you may be required to meet FINRA regulations regarding the content of your mailers. It is your obligation to ensure that your mailer/invitation is in full compliance with all applicable state and federal laws, rules and regulations. This includes the word Social Security and any Social Security images. Seminar Crowds, Inc. (SCI) assumes no responsibility for the content of your mailer or compliance with applicable laws. Any forms, templates or suggestions provided by SCI are for convenience only and it is the mailers’ responsibility to ensure that his or her mailer fully complies with applicable law. I agree that SCI shall not be responsible for any consequential damages. In no event shall SCI’s damages with respect to any individual mailings exceed the amount paid to SCI for such mailings.

This application is made at Fairfield, IA. The parties agree that all disputes shall be governed by Iowa law and consent to the exclusive jurisdiction, venue and forum of any state or federal court in Jefferson County, Iowa. Seminar Crowds shall be entitled to recover its reasonable attorney fees in any action including the collection of any unpaid invoices.

    * Agreement

Fax 641-209-3953 Phone: 641-209-3950