This Is A Printable Form
3095 Burleson-Retta Rd.
Burleson, TX 76028
817-426-0944 - FAX: 817-447-9711
Advertising Space Contract
RUN AN AD YOU ALREADY
Please run, again, my ad that appeared in the ____________________ issue of Peruvian Digest
[ ] Please bill me [ ] Please charge to my Credit Card you have on file.
Please reserve ___________________________ (size of ad) ad in the
________________________(date of issue) edition of Peruvian Digest.
Please run the ad ___________ times.
Enclosed is the:
[ ] color separations
[ ] camera-ready ad
[ ] rough draft( ____ with photo ____ no photo)
[ ] Please Fax me a proof at ____________________
Space Cost $___________________
Color Separation $___________________
Please charge to my [ ] Visa [ ] Mastercard [ ]
AMEX [ ] Discover
Number: _______________________________ Expiration Date ______________________
If you choose to run the ad more than once, we will bill you each time it runs. You do not have to pay the full amount up front.
Please print the following information:
Ranch Name _______________________________
Phone: ____________________________E-mail _________________________