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Partner Services Request Form
Choose the service you need - We've got your back:
Campaign Copy
Email Campaign Distribution
Image Upload
List Upload
Premium Design
Custom Integrations
Campaign Copy
*
A Campaign Copy is a direct recreation of an event campaign, automated email series, sign-up form or landing page originating your main partner account to one child account.
Name
Partnership/Company name:
Your email address
Originating account username:
How many child accounts will need a copy?
By checking the box below, you authorize Constant Contact to make a one-time charge for
Campaign copy in the amount (USD) of:
(
one-time charge of $299/per recreated copy in one child account)
Constant Contact will charge the credit card on file or will send you an invoice. All Constant Contact products and services are subject to the
Constant Contact terms and conditions.
You agree that we may adjust this price if the payment method on your account is not USD and that you are responsible for any taxes that may be imposed on our services.
Yes, I Agree
Client Usernames (Please enter list of usernames or type All accounts):
Campaign Title:
Campaign Type:
Please select...
Email Automation Series
Sign Up Form
Landing Page
Event
Email Campaign Distribution:
*This is a one-time distribution of an email campaign from the main partner account to all child accounts that are established at the time of the distribution.
Accounts created after that time will not have access to the emails unless a new request is made.
Name
Partnership/Company name:
Your email address
Originating account username:
Please enter the title/s of the email campaign/s:
How many email do you need to distribute?
Please select...
1
2
3
4
5
6
How many child accounts will need a copy?
By checking the box below, you authorize Constant Contact to make a one-time charge for
Email Distribution in the amount (USD) of:
one-time charge of $150 per email campaign (or $100/per if distributing three or more templates)
Constant Contact will charge the credit card on file or will send an invoice. All Constant Contact products and services are subject to the
Constant Contact terms and conditions.
You agree that we may adjust this price if the payment method on your account is not USD and that you are responsible for any taxes that may be imposed on our services.
Yes, I Agree
Image Upload:
Upload of five images per child account.
*If you require additional image uploads to one or multiple accounts,
please email
partnerservices@constantcontact.com
Name
Partnership/company name:
Your email address
Originating username:
How many child accounts will need images?
Enter child account usernames:
Upload your images (5 images):
By checking the box below, you authorize Constant Contact to make a one-time charge for Image Upload in the amount (USD) of:
($15 per set of five images per child account)
Constant Contact will charge the credit card on file or will send an invoice. All Constant Contact products and services are subject to the
Constant Contact terms and conditions.
You agree that we may adjust this price if the payment method on your account is not USD and that you are responsible for any taxes that may be imposed on our services.
Yes, I Agree
List Upload:
Please upload your contact lists. We will use the file name as the contact list name.
See how to format your file here.
*If you require additional list uploads to multiple accounts, please email
partnerservices@constantcontact.com
We require that you have permission from all of your contacts in order to email them. Learn more by reviewing
our permission policy
before submitting your contacts.
Name
Admin account
username
Partnership/Company name:
How many child accounts will need list uploads?
Enter child account usernames:
Please upload your contact lists:
By checking the box below, you authorize Constant Contact to make a one-time charge for Image Upload in the amount (USD) of:
($15 per 3 lists per child account)
Constant Contact will charge the credit card on file or will send an invoice. All Constant Contact products and services are subject to the
Constant Contact terms and conditions.
You agree that we may adjust this price if the payment method on your account is not USD and that you are responsible for any taxes that may be imposed on our services.
Yes, I Agree
Premium Design
Name
Admin account username:
Partnership/Company name:
Do you want more than one Premium Design? Additional $100 per design.
Yes
No
How many Premium Designs would you like?
Please select...
2
3
4
By checking the box below, you authorize Constant Contact to make a one-time charge for Premium Designs in the amount (USD) of:
By checking the box below, you authorize Constant Contact to make a one-time charge for Premium Designs in the amount (USD) of:
Constant Contact will charge the credit card on file with your Constant Contact account once this form has been completed. All Constant Contact products and services are subject to the Constant Contact terms and conditions. You agree that we may adjust this price if the payment method on your account is not USD and that you are responsible for any taxes that may be imposed on our services.
Yes, I Agree
Website URL
Describe the template needs:
Have a design to replicate?
Yes
No
Upload your design here:
May we use your design for marketing purposes?
Yes
No
I hereby grant Constant Contact, Inc. and its affiliates (collectively, “Constant Contact”) . a perpetual, non-exclusive, royalty-free right and license to use, re-use, and promote any and all content about me or my company or organization (including my likeness and any images, photographs, digital videos or sound recordings, email campaigns, surveys, and testimonials) that I have provided to Constant Contact, in whole or in part, or any reproduction thereof in print, color or otherwise, made through any and all media (including on the Internet, social media, in print publications, video and multimedia presentations) for marketing or informational purposes, for illustration, art, promotion, information, advertising, trade, or any other purpose whatsoever. I represent and warrant that I have (i) all rights to provide Constant Contact with the content I am providing, including, but not limited to, any photos, videos, audio, and any written material, such that Constant Contact may use such content as contemplated herein and (ii) I have received any necessary consent from any person depicted or featured in such content in order for Constant Contact to use such content as contemplated herein. I hereby agree to indemnify and hold Constant Contact, its licensees, partners, and affiliates harmless from any liability resulting from the content I have provided, including my statements and action depicted or described in the information, and any text, audio, video, images and/or graphics submitted to Constant Contact.
I understand that I may or may not have the ability to approve and verify an article or testimonial written about me or my company or organization based on the content I have provided or that Constant Contact has captured, but that I will not be able to examine or approve the completed product (or products) or the advertising copy, printed matter, videos, sound recordings, photographs or screenshots that may be used in conjunction therewith.
I understand that Constant Contact is not obligated to use my content or any rights granted to the Company hereunder.
I understand and agree that my consent is strictly voluntary and Constant Contact may or may not, without any obligation, provide me with compensation or other valuable consideration.
Constant Contact will only use the license granted hereby in a manner that it believes does not disparage you or your organization or put you or your organization in a negative light.
I have read this Consent Form and I fully understand the contents thereof. This Consent Form shall be binding upon me and my heirs, legal representatives and assigns. If applicable, I represent and warrant that I have the authority to execute this release on behalf of my company or organization.
Yes
No
Custom Integrations
The Technical Services Delivery team supports your business needs, from complex data synchronization between your CRM and Constant Contact to creating and implementing custom forms in your LGCRM account. Contact us for a no-obligation discovery call where we'll learn about your needs and connect you with an Integration Specialist.
If you're interested in proceeding, the specialist will then assess your needs and scope out a solution for a non-refundable fee of $250*.
We look forward to helping your project get launch!
Name
Constant Contact Username
Email Address
Phone Number
Company Name
Account Type
Constant Contact
Lead Gen & CRM Platform
Additional Information:
Payment Information:
Invoice or charge card on admin account?
Invoice
Charge Card
Physical Address:
Email Address::
Contact Information
