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Sponsorship Program Sign-Up Form

 

 

*Choose one or more PLACEMENTS:

Home” page advertisement - 125 pixels X 125 pixels (2 available slots)



For the Employer” page advertisement - 125 pixels X 125 pixels
(2 available slots)

6 month advertisement  = $900 US

For the Representative’ page advertisement - 125 pixels X 125 pixels
(2 available slots)

6 month advertisement  = $900 US

ADVERTISEMENT INFORMATION:

Please upload your advertisement image from your hard drive (125X125 gif, jpg, png, flash, bmp)
URL/Website address that ad will link to: (i.e. http://mysite.com)
Alternative text to display (i.e. short description of ad)
Notes, comments, or special instructions

Billing Information:

*First Name
*Last Name
Company
Address Line 1
Address Line 2
*City
*State/Province
*Zip Code/Postal Code
*Country:
*Email address
*Telephone Number
 
*Card Type
*Card Number
*Expiration Date
*CVV Code

 

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