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Application to Advertise My Business
Owners Name:_________________________
PLEASE PRINT
Owners e-mail:__________________________
OWNER'S INFORMATION:
Address:______________________________
_____________________________________
City/State/:_____________________________
BUSINESS INFORMATION:
County:__________ Home Ph:_____________
Bus. Ph.:__________ Cell:________________
DIRECTIONS TO SUBMIT APPLICATION: Print this page out on your printer. Fill out entire form. Write in all information & check all appropriate spaces. Mail this form to:
George Nagy
Business Advertising Rates
:
Advertise for 60 Days ($129.00)_____
Advertise for 1 Year ($209.00)_____
Advertise for 1 Month ($29.00)_____
*** Additional pages linked to your main ad such as a restaurant menu, listing of a large amount of items for sale, etc., will be charged a on time fee of $79.00.
Business Name:___________________________ Information: You would like placed in your ad:
(Please Limit to 40 words or Less)
Business Address:
______________________________ ______________________________
City/State/:______________________
Business Ph. # :__________________
I acknowledge that I have read and agree with the Terms and Conditions of this site.Please check here.___
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