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(*Indicates required fields)

*First Name
*Last Name
*Street Address
Address Cont.
*City *State
*Zip - Country

Choose one of the following options:

Web text ad ($125.00) prepayment required
E-newsletter text ad ($125.00) prepayment required

Type the text of your ad or indicate that display ad is being sent:*

You may also submit your ad copy (or check on the status of a placed order) by emailing .(JavaScript must be enabled to view this email address).

If paying by credit card, please write "Credit Card" in the Purchase Order # box. Do not enter your credit card number here. The payment link will appear immediately after you submit the ad. Prepayment is required for all online postings. No purchase orders will be accepted for on line ads. If paying by check for newsletter ads and wish to be billed, enter Purchase Order #. If you plan to issue a check without our billing you, you do not need to enter a Purchase Order #-- simply write check in the Purchase Order # box.

  Billing Information
* Purchase order #
* Account name
* Street address
Address (cont.)
* City
* Zip/Postal code -