QVC

Cross-Channel Spot Update Form

Directions: Fill in this form to update your current QVC cross-channel spot information or if you would like to receive QVC cross-channel spots. Print this form and fax to 484.701.1350.

Name:

Title:

System Name:

Office Address/PO Box:

City: State: Zip:

Office Phone: - -    Ext:    Fax: - -

Direct Line: - -    Ext:    Fax: - -

E-Mail:

Please check one box below:

Please continue to send me QVC cross-channel spots. I am updating the above information only.

Please change the QVC cross-channel spot format I am currently receiving to the following:

Beta SP           DVD

I would like to receive QVC cross-channel spots. Please send me the following format:

Beta SP           DVD

I do not wish to receive QVC cross-channel spots any longer. Thank you.

Print this form and fax to 484.701.1350. Thank You!