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PROSPECTIVE FRANCHISE LICENSEE FORM

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Mobile Media
Use Mobile Media for:
• Trade Shows
• Conventions
• Special Event
• Product Introductions
• Grand Openings
   

Please complete this application as thoroughly and as accurately as possible.

The information you provide is secure and private.

This data will enable The Mobile Media Group Inc. help you to take the first step towards becoming an official Licencee with our organization.

ALL INFORMATION IS REQUIRED
First Name
Last Name
Phone
Fax
Best Day/Time to Call
Address
City
State
Zip
Country
E-Mail
Current Occupation
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Animation shown is for promotional purposes only and in no way indicates actual movement of billboard. Patented poster panel interchange allows the option for changing billboards in 20 minutes. Also shown is our patented lighting system, so your clients get a "back-lit" effect without the expense.