Advertising Order

You must complete each blank below. If there is something that you do not want listed, such as an address, please write "Do Not List" in that space.

Business Name :

Website Address:

Words describing your business as you want it listed (80 max):

Address, including City, State, Zip:

Do you want a "Map Link" to your address? Yes -- No

Phone Number: Ext.

Type of Business (such as Real Estate, Restaurant, Gifts, etc) so that we can determine which page is most appropriate for your listing:

Are you interested in adding a coupon? Yes -- No
(We will call you for details and to help design it)

--- Please provide the following for billing purposes ---
No credit card information is required - we invoice you!

First & Last Name:

Address: Same as above

Phone Number: Ext.

E-mail Address:

Where/How do you currently advertise, if any:

Thank you for advertising with us. We look forward to working with you.

For verification purposes a member of our staff may contact you to verify that you placed the order before we publish it.