Classified Ad Submission Form
Print this page and complete.
| Demographic Information | |
| Name | ___________________________________________________ |
| Street Address | __________________________________________________________ |
| City | ________________________________ |
| State | ________________________________ |
| Zip Code | ______________ |
| Telephone | ______________________ |
| E-mail Address | ________________________________ |
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Ad Information |
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Write your ad below:
My ad has __________ words. Therefore, my payment is for $_________ |
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Please mail your check or money order with a copy of this completed form to:
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