| |
CONTACT
INFORMATION (for hrVillage use only; company info
to be included in listing should be provided below) |
| |
Business
Name:_____________________________________________________________________ |
| |
Contact
Name:___________________________ |
Email:____________________________________ |
| |
Address:___________________________________________________________________________ |
| |
City:___________________________________ |
State/Province:_____________________________ |
| |
Postal
Code:____________________________ |
Country:__________________________________ |
| |
Phone:_________________________________ |
Fax:_____________________________________ |
| |
|
|
| |
DIRECTORY
LISTING ORDERED (also complete information below,
as required by listing type ordered) |
| |
1.
Check ONE box below to designate listing type you want
to order.
2. Complete only the sections below (A thru E) required
for the listing type you ordered.
3. Complete CONTACT INFORMATION (above) and PAYMENT
INFORMATION (below for all listings other than "Basic").
|
| |
|
 |
| |
LISTING |
COST |
SECTIONS
TO BE COMPLETED BELOW |
|
| |
Basic
Listing |
No
Charge |
A
and B only |
 |
| |
hrCONNECT |
|
|
|
| |
6
months |
$200
($175 if ordered
before 10/01/00) |
A,
B and C |
|
| |
12
months
|
$350
($300 if ordered
before 10/01/00)
|
A,
B and C |
|
| |
hrEXTEND |
|
|
|
| |
6
months |
$450
($400 if ordered
before 10/01/00) |
A,
B, C and D |
|
| |
12
months
|
$825
($750 if ordered
before 10/01/00) |
A,
B, C and D |
|
| |
hrBRAND |
|
|
|
| |
6
months |
$650
($575 if ordered
before 10/01/00) |
A,
B, C, D and E
|
|
| |
12
months
|
$1200
($1100 if ordered
before 10/01/00) |
A,
B, C, D and E
|
|
| |
Start
Date: _____________________________ |
End
Date: _______________________________ |
|
| |
|
|
|
| |
PAYMENT
INFORMATION (please do not send cash) |
| |
Payment
Amount: ________________________ |
Name
(please print): _____________________ |
| |
Check
Number: __________________________ |
Signature:
_____________________________ |
| |
|
|
| |
INSERTION
ORDER AGREEMENT |
| |
By
completing and signing this insertion order, the advertiser/agency
agrees to the terms set forth above and on the attached
General Terms and Conditions: |
| |
Signature:_______________________________ |
Date:
__________________________________ |
| |
Title:
___________________________________ |
Company:
______________________________ |
| |
|
|
| |
|
|
| |
Section
B (complete for all listing types) |
| |
Business
Name: _____________________________________________________________________ |
| |
Address:
___________________________________________________________________________ |
| |
City:
___________________________________ |
State/Province:
___________________________ |
| |
Postal
Code: ____________________________ |
Country:
________________________________ |
| |
Voice
Number: __________________________ |
Fax
Number: ____________________________ |
| |
|
|
| |
Section
C (complete for hrConnect, hrExtend, hrBrand listings) |
| |
Web
Site URL (includes hyperlink): http://________________________________________________ |
| |
Contact
Name (to appear in listing): ____________________________________________________ |
| |
Contact
Voice Number: ____________________ |
Contact
Email Address: ___________________ |
| |
|
|
| |
Section
D (complete for hrExtend, hrBrand listings only) |
| |
Description
of goods/services (up to 100 words; include URLs as
<http://...> to denote hyperlinks to product web
pages where desired):
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
|
| |
|
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