Patsy's On-line Advertising Payment Form
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Ad size Full page - B/W Full page - color Half page - B/W Half page - color Red Carpet Page - B/W $100 Red Carpet Page - Color $300 Centerfold - Color $900 Natural Inside Front Cover - Color $600 Other Other Description Name Company Name (if any) Website address (if any) Address City State Zip Phone with area code Email Which section of the magazine do you prefer? Natural Glitz Type of Card Visa Mastercard Discover/NOVUS American Express Paypal When paying by Paypal, please put X's in the Card # box below....then send Paypal payment to patsysmag@aol.com or patsyspage@aol.com Card # Security Verification Number Name as it appears on card Expiration Date Total Payment $
Ad size Full page - B/W Full page - color Half page - B/W Half page - color Red Carpet Page - B/W $100 Red Carpet Page - Color $300 Centerfold - Color $900 Natural Inside Front Cover - Color $600 Other Other Description
Ad size Full page - B/W Full page - color Half page - B/W Half page - color Red Carpet Page - B/W $100 Red Carpet Page - Color $300 Centerfold - Color $900 Natural Inside Front Cover - Color $600 Other
Other Description
Name
Company Name (if any) Website address (if any)
Address
City State Zip
Phone with area code
Email
Which section of the magazine do you prefer? Natural Glitz
Type of Card Visa Mastercard Discover/NOVUS American Express Paypal
When paying by Paypal, please put X's in the Card # box below....then send Paypal payment to patsysmag@aol.com or patsyspage@aol.com
Card # Security Verification Number
Name as it appears on card
Expiration Date
PATSY'S MAGAZINE
4215 SE 11th Place, OCALA, FL 34471 Phone (352) 694-5619 FAX ONLY (352) 694-7942
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