Insertion Order for Advertising

							INSERTION ORDER                                                                                         Date:_________

Client Account # _______ Insertion # ___________ Sales # ______


ADVERTISER INFORMATION:
Company Name ____________________________________ Contact _________________________
Agency Name ______________________________________ Contact __________________
Address _____________________________ City __________________ State ____ Zip: _________
Phone: _____________________ Fax: ___________________ Email: ________________________


INSERTION SCHEDULE:

ISSUE                         AD SIZES & RATES                        1x               3x              6x               12x
           Jan                        1 Col x 2 inches              $240             $230            $215             $200
           Feb                        1 Col x 3 inches              $340             $325            $300             $285
           Mar                        2 Col x 2 inches              $440             $420            $390             $375
           Apr                        2 col x 3 inches              $540             $515            $490             $460
           May                        ¼ page                        $770             $725            $695             $650
           Jun/July                   ½ page                        $1,210           $1200           $1185            $1,140
           Aug                        Full Page                     $2,440           $2,360          $2,325           $2,250
           Sep
           Oct
           Nov
           Dec




TOTAL: __________

PAYMENT INFORMATION: All payments are to be PREPAID.
I understand that my credit card number _________________________________________________ Exp. ________
will be charged in accordance to the above insertion schedule chosen by advertiser. When a multiple insertion schedule is in effect,
your credit card will be charged in a monthly manner and your ad will be picked up from the previous month. No cancellations will
be accepted prior to the “Press Date” or a cancellation fee will apply. No cancellations will be accepted without written notification.
Please note that your below signature is permission for [COMPANY] to periodically communicate via email & fax.
X   _________________________________________________ Date ____________________
Signature (Your signature accepts responsibility of this insertion schedule)
___________________________________________________ Date ____________________
Print
_______________________ _______________________ _____________________________
Phone                                    Fax                                       E-mail

2009 CLASSIFIED ADVERTISING