To join Media Matchmaker, fill out the application data below and learn about our fee and billing structure. Your patience during this step is appreciated. We screen all applicants in person, rather than automatically, to ensure the authenticity and credentials of those using this site. Below you will also find some basic information on the fee and billing structure.

NAME: TITLE: COMPANY: ADDRESS: ADDRESS 2:		CITY: STATE: Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP: E-MAIL: PHONE:
BRANDS YOU CURRENTLY REPRESENT AND PLAN TO USE ON THE SERVICE: YOUR AGENCY'S ANNUAL INCOME: HOW DID YOU HEAR ABOUT MEDIA MATCHMAKER?: Select Press Article Internet Search Referral Attended an Event Your Staff Contacted Me Other    IS ANYONE IN YOUR COMPANY IN DISCUSSIONS WITH ANY MEDIA MATCHMAKER REPRESENTATIVE ALREADY? IF SO, WHAT IS THE NAME OF THE EMPLOYEE?: I UNDERSTAND THAT MEDIA MATCHMAKER DOES NOT ALLOW PRODUCTS TO BE LISTED THAT THEY DEEM TO BE PORNOGRAPHIC OR UNSUITABLE FOR THE GENERAL PUBLIC, AND MAY REMOVE ANY PROGRAM FROM THE SERVICE THAT THEY DEEM, IN THEIR SOLE DISCRETION, TO BE OF SUCH NATURE.

Fee Structure
We charge a monthly subscription fee based on the number of brands you list on the service. The fee is structured on a per brand, per month basis.

Payments Methods
All payments are required prior to service each month. We do not offer "Net 30 day billing." Acceptable forms of payment are:

• Visa
• Mastercard
• American Express
• Wire Transfer
• Cashier’s Check
• Money Order
• ACH-Automatic Clearing House - an electronic debit to your company checking account
• Company Check - the check must be cleared before service starts on the first of each month
  
  

Thank you for applying. We will be in touch shortly and can answer your questions in detail.