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Company Name:

First Name:

Last Name:

Email:

Phone:

Street Address:

State or Province:

Zip/Postal Code:

Publisher Details

URL:

Please upload a .csv file:

Monthly video views:

Video ad server:

Content (check all that apply)

 Video Game Music App

Inventory (check all that apply)

 Desktop Mobile Web App Connected TV

Player Size (check all that apply)

 Small Player (<300x250) Medium Player (301x251 - 479x319) Large Player (>480x320)

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