Buyer Signup Form

 
General Information
Provide a link to a high resolution (minimum 500x500 pixels) image of your company's logo
http://
http://
Approximate number of logins needed for the BrandVerge platform
Account details
Detail any agencies you would like to have associated with your account. Enter N/A if not applicable
List all accounts, brands, and products that will use the BrandVerge platform
Name your preferred ad serving platform(s)
Name your preferred media buying system(s) examples: Mediaocean, Prisma, Strata, etc.
Admin contact
The admin controls your company’s BrandVerge usage. This user can create company logins across the portfolio, assign new users, individual brand/product admins and manage permission levels across the organization.
Name *
Name
Phone Number
Phone Number
Technical contact
The person at your company who BrandVerge can contact to troubleshoot bugs, notify of platform updates/outages, and complete technical work on product integrations
Name *
Name
Phone number
Phone number
Finance contact
The person at your company who BrandVerge can contact regarding invoices and billing, (if applicable)
Name *
Name
Phone number
Phone number
Business contact
The person at your company who will own the business relationship with BrandVerge, evaluating new product opportunities and managing the overall partnership.
Name *
Name
Phone number
Phone number