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   Onlinephotostories -- Sign-up Form

    Please fill out this form, print, and fax or mail (addresses at bottom) to our office for quick sign-up for the July, 2008 issue.

    This form is a convenience for printing purposes - no information is sent over the Internet.

Number and Type of ad(s)		New Ad		+ Repeat Previous Ad
Online Storyboard		$300		+ $50
Repeat storyboard only		$150		n/a
New Killer Shot		$90		+ $15
Repeat Killer Shot only		$45		n/a

Name:
Company:
Address:
City,State,Zip:	,    Zip:
Phone:	Fax:
Email:
Website:
Credit Card Information:
	Total to be billed:   Card Number:   Expires:   (mm/yyyy) Security Code   (MC or Visa - 3 numbers, Amex - 4 numbers) Billing address:   (if different)   Signature:   _________________________________________
Check Enclosed:	(check #) (we can only accept checks drawn on a US bank, or money orders in US funds)

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