Please provide your contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

AD PACKAGES are payable in advance. An advertising representative will be in touch with you about producing your ad spot and your web advertising banners.

What ad package do you want?

NATIONAL AD PACKAGE @ $50 WEEKLY INTERNATIONAL AD PACKAGE AT $200 WEEKLY CBS AD PACKAGE AT $150 WEEKLY

How many weeks?

ONE WEEK TWO WEEKS THREE WEEKS FOUR WEEKS

CALL (401) 651-7732 FOR SPECIAL RATES ON LONG-TERM CONTRACTS (OVER FOUR WEEKS)

PAYMENT INFORMATION

1. YOUR FIRST INSERTION MUST BE PAID IN ADVANCE. THE PRODUCERS RESERVE THE RIGHT TO REQUIRE PREPAYMENT FOR ANY SUBSEQUENT ADVERTISEMENT

You may pay with MasterCard, VISA, AMEX or DISCOVER. Please provide payment information:

	BILLING
Credit Card	VISA MasterCard American Express Discover
Cardholder Name
Card Number
Expiration Date

IF YOU WISH TO PAY BY CHECK, SEND YOUR CHECK, PAYABLE TO NEW RIVER PRESS, AND INSERTION ORDER, to New River Press, 645 Fairmount St, Woonsocket, RI 02895. 

YOUR PURCHASE ORDER NUMBER: