Clarivate Analytics

First Name*

Last Name*

Job Title*

Job Role*

Business email address*

Business Phone*

Organization Name*

Organization Type*

City*

State or Province

Country/Region*

How can we help you?

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The name of your form you are creating.

SBU of Lead

Primary Product

Sub Primary Products

Lead Source - Most Recent

To find this, go into SFDC and go to the Campaign, copy and paste the 15-digit ID from the Address Bar. e.g. If address bar is https://na5.salesforce.com/70170000000IXom, insert ONLY 70170000000IXom.

To which campaign do you want this lead attached? Please insert the EXACT campaign name.

Last Follow Up

Lead Routing

Lead Status

Marketing Lead Status

Full name of asset for MailMerge

Example: Email Name

utm_medium

utm_source