THE HOLMES REPORT
ONLINE AGENCY DIRECTORY

SECTION ONE: BASIC AGENCY INFORMATION

AGENCY NAME
_________________________________________________

ADDRESS
_________________________________________________

_________________________________________________

CITY
_________________________________________________

STATE/PROVINCE
_________________________________________________

ZIP
_________________________________________________

COUNTRY
_________________________________________________

PHONE
_________________________________________________

FAX
_________________________________________________

NEW BIZ CONTACT NAME
_________________________________________________

IF YOU WISH TO SUBMIT BASIC LISTING INFORMATION ONLY, SIMPLY E-MAIL
(PHOLMES@HOLMESREPORT.COM) OR FAX (212 333 2624) THIS SINGLE SHEET.

IF YOU WISH TO SUBMIT AN ENHANCED LISTING ($200 PLUS $10 FOR EACH
ADDITIONAL OFFICE), PLEASE PROCEED TO SECTION TWO

SECTION TWO: ADDITIONAL CONTACT INFORMATION

YOUR WEBSITE URL
_________________________________________________

NEW BIZ E-MAIL ADDRESS
_________________________________________________

RECRUITMENT CONTACT
_________________________________________________

E-MAIL ADDRESS
_________________________________________________

SECTION THREE: ADDITIONAL AGENCY DATA

2000 PR FEES (optional)
_________________________________________________

NUMBER OF EMPLOYEES
_________________________________________________

PARENT COMPANY (if any)
_________________________________________________

SECTION FOUR: OPTIONAL EXTRAS

Please attach a disk (or e-mail information to pholmes@holmesreport.com) to provide:

(a). A statement of your agency's philosophy, approach, expertise, etc. (max. 250 words)

(b). A list of current clients

(c). A list of senior executives (senior VP level and above only, please)

(d). A list of additional offices in other cities, including the name, address, phone and new
business contact information for each office.

Please attach disk or URL if you would like to provide:

(a). Your logo

(b). Link to video on the web you would like potential clients to see

(c). Link to video on the web you would like potential recruits to see

SECTION FIVE: AREAS OF EXPERTISE

Please circle those areas in which your firm has experience and expertise:

AGRIBUSINESS
ARTS & LEISURE
ASSOCIATIONS
AUDIO-VISUAL
BIOTECHNOLOGY
BUSINESS-TO-BUSINESS
CAUSE-RELATED PR
COMMUNITY RELATIONS
CONSUMER PRODUCTS
CORPORATE IMAGE
CRISIS MANAGEMENT
EMPLOYEE RELATIONS
ENTERTAINMENT
ENVIRONMENTAL PR
FINANCIAL SERVICES
FOOD & BEVERAGE
GOV'T AGENCIES
HEALTH & MEDICAL
HIGH-TECH
INTERACTIVE SERVICES
INTERNET/E-COMMERCE
INTERNATIONAL
INVESTOR RELATIONS
MEDIA TRAINING
MINORITY MARKETS
OVERSEAS GOVTS.
PROFESSIONAL SERVICES
PUBLIC AFFAIRS
REAL ESTATE
SOCIAL MARKETING
SPONSORSHIP
SPORTS MARKETING
TRAVEL & TOURISM
YOUTH MARKETING

SECTION SIX: PAYMENT AND ADMIN

An enhanced listing costs $200 (plus $10 for each additional office). Please provide us with payment
information and the name of the administrative contact for this listing.

Contact Name
_________________________________________________

Contact E-mail Address
_________________________________________________

TOTAL ENCLOSED $200 plus ___ offices at $10 each TOTAL ______

___ Payment attached

___ I would prefer to pay by credit card

Name on credit card
_________________________________________________

Credit Card #
_________________________________________________

Expiration Date
__________________

Signature
_________________________________________________

PLEASE RETURN TO: GDRURY@HOLMESREPORT.COM
FAX: 212 333 2624
MAILING ADDRESS:
271 W 47TH ST.,
Suite 23-A,
New York, NY 10036