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Name
Organization/Company
Address
City
State
ZIP
E-mail
FAX (Pls include area code)
Phone (Pls include area code & ext.)
Please Choose Ad Size(s)
Premium Positions (Full Units Only)
Color



Listing Copy (see rate card)
Additional Information
Ad Cost (see rate card)
Total Due
Permissions



To complete your reservation, please click the "RESERVE AD" button below.

Finalize it by mailing your payment to 4411 Bee Ridge Rd.,#195, Sarasota FL 34233

If your order is the same for all publications, you don't need to complete this form multiple times. Just use the additional info section to tell us of minor differences, if any. If it's complicated, please complete this form again. But please note there are differences in rates and word allowances.

To order an optional web site banner ad for ads less than 1/4 pg, Click here