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To present advertising opportunities to our Media Buyer

(no product or order questions), please complete and submit this form.

Fields marked with *are required for a reply from our Media Buyer
*Your Full Name:
*Email Address:
*Phone:
*Publication Name:
*Your Company Name:
*Media Type:
(Magazine, web advertising, etc)
*Circulation:
(For Magazines-Rate Base/Sold copies per issue,
For Web-impressions/day)
*Circulation verified?:
(if yes-by whom)
*Your Sales Authority:
(What is your relationship to the ad publisher)
----Please select one----
URL of your publication:
*Comments:
What are you selling?
Print ads: include size or section information
Web ads: include urls of live web ad samples for evaluation


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