Advertising Sales Form

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					Highway Hotspots Travel Network Advertising Sales Form
------------------------------------------------------------ Business Listing -----------------------------------------------------------Business Name: _______________________________________ Contact Name: ______________________ Address: ________________________________ City: _________________State: ___ Zip: _______ - _____ Tel: ___-___-____ x ___ Fax: ___-___-____ Email: _______________________Web: __________________ ------------------------------------------------------- Advertising Information ------------------------------------------------------(e.g. Adair, I 80 Exit 121)

Highway Hotspot/Exit

Attraction,Food,Gas, Lodging,Service

Category

(e.g. S 0.5 mi.)

Directions

Advertisement (See Rate Card) * Option Type Price (Exit Listing) (e.g. Small) (per mo.)

Total
* All hotspot advertising is billed on a quarterly basis and renews automatically until cancelled. Include the following: 1. Advertisement: Email digital ad to Support@WirelessTravelPromotions.com 2. Promotional Message Text: (Use reverse side) 3. Ad link URL:

-------------------------------------------------------- Billing Information --------------------------------------------------Payment Type: __ Invoice __ CC: AE D MC V Card# ______________________ Exp. ___/___ CV2 ____ Business Name: _____________________________________ Contact Name: ________________________ Address: ________________________________ City: _________________State: ___ Zip: _______ - _____ Tel: ___-___-____ x ___ Fax: ___-___-____ Email: _______________________Web: __________________ Authorized Signature ____________________________ Title ___________________ Date _____________ Please complete and return by Mail: 5151 Robertson Drive, Des Moines, IA 50312


				
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