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IN.gov Web Portal > ExactTarget > ExactTarget Order Form ExactTarget Order Form

Required fields:

Contact Information

Executive Branch Agencies are required to have an approved Communication Plan. Does your agency/program have an approved communication plan from the Office of Management and Budget with Exact Target identified as a line item?

Agency Name:

Department:

Program:

Name:

Title:

E-mail Address:

Work Phone:

Select ExactTarget Services

Everything below, is a agency requirement. So the agencies that wants the additional information when invoiced will supply it.

Desired Start Date:

Order Type
Initial term Renewal term Upsell

E-mail Address for Software Delivery:

Package Selection:
Basic ($500) Advanced ($3,000) Enterprise ($7,500)

Email Selection

Pay-as-you-go Email

Bulk Email Purchase

# of Emails

per email rate

Feature / Service	ExactTarget SKU	Annual Price

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Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments
Feature / Service	ExactTarget SKU	Annual Price

Comments

Agency Billing Information

Billing Contact Name:

Billing Contact Title:

Billing Contact E-mail Address:

Billing Contact Work Phone:

Fund:

Department:

Program:

Special Billing Instructions (If Any):
No Fund/Center

Project (if required):

If using project the following are required:

Activity Code:

Analysis Code:

Other codes that may be required by agency:

Source Type:

Service Category:

Source Sub Category:

Locality:

Incident:

Other Information

Add a Message (Optional):

The requestor is authorized or has received approval to request these services for their agency:

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