SUBMIT AN AD FORM - Include Phone # and Price.

First Name *

Last Name *

Company Name/Private - optional

Credit Card Billing Address - Street/P.O. Box * 🛈

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

How did you hear about us? - Where have you seen us?

AD SIZE & PAYMENT:

Select ad size & number of issues: Save when you schedule your ad for 2 issues! *

STANDARD AD - $28 for 1 Issue (2 weeks)	STANDARD AD - $50 for 2 Issues (4 weeks)
JUMBO AD - $55 for 1 Issue (2 weeks)	JUMBO AD - $100 for 2 Issues (4 weeks)

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Security Code from Credit Card (CID/CVV code-not your secret PIN) *

Please attach your photo(s): * 🛈