About this template
An insertion order form is an essential contract document used by advertising agencies, media departments, and publishers to authorize and finalize print or digital ad placements. This structured template collects critical campaign details such as run dates, ad dimensions, pricing, creative instructions, and billing contacts in one organized place.
By moving your advertising intake process to Doc2Form, you eliminate messy paper trails and unformatted email requests. Advertisers and clients can submit their exact ad specifications, captions, and design instructions directly into a structured format that seamlessly connects to your team's workflow. This ensures complete clarity between media buyers, creative teams, and finance departments, preventing costly miscommunication on live campaigns.
Key features
- Capture complete print and digital ad specifications in a single submission.
- Standardize run dates, sizing, and pricing calculations for every campaign.
- Collect billing instructions, account IDs, and proof contacts instantly.
- Simplify creative handoffs with dedicated sections for ad captions and design notes.
Use cases
Booking magazine or newspaper print display ads and classifieds.
Securing digital banner campaigns and sponsored newsletter placements.
Managing in-house agency ad requests from internal department stakeho…
Managing in-house agency ad requests from internal department stakeholders.
Processing media buying agreements for external clients and agency pa…
Processing media buying agreements for external clients and agency partners.
What this form collects
- Advertiser / Company Name (Short answer)Enter the legal business name or brand placing the advertisement.
- Agency / Account ID (Short answer)If applicable, provide your agency name and internal account ID number.
- Salesperson / Account Manager (Short answer)Enter the name of the media rep or sales contact managing this order.
- Advertising Type (Multiple choice)Select the primary medium for this campaign.
- Ad Number or Campaign ID (Short answer)Enter the tracking number or internal campaign code if assigned.
- Campaign Run Dates (Date)Specify the scheduled start date for the ad insertion.
- Pick Up Status (Multiple choice)Indicate whether this is new creative or a repeat placement.
- Previous Run Date (Date)If picking up a previous ad, enter the date it last ran.
- Ad Sizing & Dimensions (Columns and Inches) (Short answer)For print ads, specify column width and vertical inches (e.g., 3 cols x 5 inches).
- Total Ad Inches / Space (Short answer)Enter total column inches or digital banner dimension specs.
- Color Specifications (Multiple choice)Select the color format for the ad insertion.
- Ad Caption and Headline (Paragraph)Provide the headline, body text, or website landing page URL for the ad.
- Design and Artwork Instructions (Paragraph)Paste links to your cloud-stored creative files (Google Drive, Dropbox) or add specific design instructions.
- Proof Recipient Contact (Short answer)Enter the name and email address of the person who should review and approve the final ad proof.
- Rate and Pricing Structure (Paragraph)Enter the agreed rate per unit, contract discounts, color charges, and total calculated price.
- Billing Instructions & Section (Paragraph)Provide the billing contact, purchase order number, and specific invoicing notes.
FAQ
What is an insertion order form used for?
An insertion order is a formal contract issued by an advertiser to a publisher or media outlet. It outlines the details of an advertising campaign, including placement, run dates, total cost, and creative specifications.
How can I customize this template for my agency?
You can easily modify questions, add custom branding, or adjust pricing fields to match your specific rate card and advertising inventory using Doc2Form.
Can clients upload artwork directly through this form?
While Google Forms collects text and link data, you can instruct clients to paste shared cloud storage links (such as Google Drive or Dropbox) in the design instructions field to deliver high-resolution ad assets.
Who typically fills out this form?
Media buyers, brand marketers, small business owners, and agency account managers fill out this form to formally request and lock in their ad placements.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.