First Name
Last Name
What is your email address?
*
What team are you on?
Annuity Marketing
Creative Account Management
common.other_option
Advisor First Name
Advisor Last Name
AEC Profile Link
Advisor Status
AE Advisor - Fully Onboarded with Creative
Recruit – Advisor is being recruited to come to AE
Winback – Advisor was previously with AE
common.other_option
What type of request is this?
New Media Campaign
Media Expansion – Advisor is currently using AEM and looking to expand
1-on-1 Visit / In-Person Meeting Prep
Advisor is currently facilitating media independently, and is interested in utilizing AEM services
1-on-1 Visit / In-Person Meeting Prep Details
Please provide the visit date, advisor/office, and any key details or context we should know ahead of the planning meeting.
Which media teams does this advisor work with?
TV
Radio
Digital
What other advertising or marketing are they running?
What service is this intake for?
TV Campaign
Radio Campaign
Digital Campaign
Second Opinion from Media Buying Team
What second opinion option would you like?
Review of Existing Media Placements (submitter will need to provide current placement details)
Proposal Review — Station-submitted proposal (upload if available)
To begin any review, we must have either the station proposal or the current airtimes. Please attach the document when submitting the request. If you're unable to attach it, email it directly to
[email protected]
What media channel is this proposal for?
TV Proposal
Radio Proposal
Upload proposal or current airtimes
What is the advisor's primary goal for this campaign?
e.g., generate new leads, promote an event, build brand awareness in a new market, re-engage past clients — be as specific as possible
TV Market
What type of TV campaign is the advisor looking to run?
What type of radio campaign is the advisor looking to run?
What city or geographic area should the radio campaign reach?
What type of digital campaign is the advisor looking to run?
High-Net-Worth Offer
Branding
Event Marketing
Coaching
Not sure yet
What city or geographic area should the campaign reach?
Does the advisor have an existing Facebook Business profile?
Yes
No
How does this advisor's office currently follow up with new leads?
CRM software, email platform, manual outreach — include tool name if known.
Who in the advisor's office is responsible for following up with leads?
Name and role if known
AEM - Campaign Budget
$25,000 and under
$25,000 – $50,000
$50,000 – $75,000
$75,000 – $100,000
$100,000+
Budget not yet determined
Budget not yet discussed
Who is the best person in the office to have a Media Discovery call with?
Office Contact Name
Contact's Role
Preferred Contact Method
Email
Call
common.other_option
Contact's Email
Contact's Phone
Is there anything else we should know about this advisor or this request?
Optional — include context about timing, sensitivities, prior conversations, or anything that would help the media team prepare.