Ad Contract and Insertion Order

Advertiser (Firm Name):

Contact / Authorized by (Name):

Contact / Authorized by (Title):

Address:

City:

State:

ZIP Code:

Fax:

Email:

Cell:

The above-named firm hereby agrees to the purchase of advertising space according to the specifications and the costs indicated below. Please send one (1) Contact/Authorizer per advertiser or firm, and one (1) address to which the invoice and tearsheets may be mailed.

The firm understands that advertising may be canceled no later than 10 business days prior to publication and that payment is due within 30 days of publication. This contract is subject to the cancellation for the violation of the Standards of Advertising Acceptability, available on request.

Advertising Submissions Deadline

(The deadline for advertising submissions for each issue is 10 days before the date indicated above.)

Questions / Comments (Optional):

Payment / Invoicing Contact:

Will the person listed as "Contact/Authorized by" be also the person who will handle payment/invoicing inquiries? If the answer is "No" please provide contact information for that person. Otherwise leave blank.

Choose:

Yes

No

Contact Name:

Contact Title:

Address:

City:

State:

Zip Code:

Fax:

Email:

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