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Product Submission Information

We thank you for taking a moment to answer the following questions in order to best evaluate your product.

What we look for in new product:
    -Not yet sold in retail stores
    -Be extremely visual and demonstratable
    -Perceptibly beneficial to consumers and offer genuine value
    -Impulse driven
    -Consumable in order to encourage repeat buys and backend continuity sales

Please fill out the form below and click the "Send Message" button. Fields marked with * are required. We will respond promptly when we receive your submission.

Note: we are unable to handle customer service inquiries received from this form.
First Name*:
Last Name*:
Address*:
Address:
City*:
State (U.S.):
State/Province (outside U.S.):
Zip/Postal Code*:
Country*:
Phone*:()
Fax:()
Cell phone:()
Email*:
Product Category:
Other - Please explain:
Does your product have a name? YES    NO
Product Name:
Identify the unique selling points, features, and benefits of your product. (Please check all that apply.)
Mass Consumer Appeal
Solves a Problem
New/Unique/Nothing else like it
Demonstratable
High Perceived Value
Other - Please explain:
Please describe your product and its benefits:
Are you the... (Please check all that apply.)
Owner
Manufacturer
Agent
Expert
Spokesperson
Do you have the exclusive rights to the product? YES    NO
Does the product have... (Please check all that apply.)
Patent       Patent number:
Patent Pending
Trademark
Expert
Copyright
None of the above
If the product is patented, in what countries?
What is the estimated cost of goods delivered?
What is the suggested retail price?
Do you have an MPEG4 format DVD of someone demonstrating the product? YES    NO

If yes, please mail to:

  Permission Interactive, Inc.
  Attn. Director of Marketing
  6070 Mission Gorge Road, Suite 1
  San Diego, CA 92120
Please list at least 5 claims you can make about your product.
Are there clinical studies supporting these claims?YES    NO
Have you ever started or completed an infomercial or TV spot for this product?YES    NO
If it aired, what were the results?
Is the product currently being marketed anywhere in the world?YES    NO
If so, how? (Please check all that apply.) TV-infomercial
TV-spot
Radio
Distributors
Retail stores
Tradeshows
Print advertising
Other   
Are there exclusive worldwide marketing rights available?YES    NO
Do you have printed brochures or sales sheets?YES    NO
Do you have testimonials from people who have used your product?YES    NO
Is there a spokesperson or celebrity associated with your product?YES    NO
If yes, who?
In what stage is your product?
Are there any related products, free give-aways, or add-ons for this product?YES    NO
If yes, please explain:
How did you hear about us?
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