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Banner Ad Application 

Banner impressions are $1 US / Cdn per click-through, in blocks of 100.

Complete this form once per banner you wish to purchase. 

Company name:
Contact name:
Address:
City, State/Prov, Country:
Postal/ZIP:
Phone:
Fax:
Email address:
URL you want the ad to be linked to:
Number of blocks of 100 click-throughs I wish to purchase:
  

We will fax you an order confirmation form. Your order will only be processed when we have received your signed order confirmation sheet and payment has been authorized.


Please email your banner ad image(s) to webmaster@pluscommunity.com.

This banner's file name:


Type the following word:


    


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Page last updated July 22nd, 2015
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