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Advertising Application
 
Advertising Application for Ads paid online via PayPal
 
Basic Business Information
This section contains the basic business information.
* Business Name:
* Address 1:
Address 2:
* City:
* State:
* Zip Code:
ex: 55104
Business Phone # (xxx) xx-xxxx:
ex: (612) 555-1234
* Contact:
* Email Address:
Hours that your business is open, if applicable. If seasonal, give the dates that it is open.
Hours:

Extended Business Information
Enter the additional information that will be included with your enhanced listing (A2, B2)

The website address below will be used only for the advertising levels that include a link to your site.

Your Website Address:
General business category. Select the category for your business below. If the appropriate category is not listed, enter the category you would like in the Special Instructions field below. We will try to accommodate your request, but will place your business in the best category possible if we cannot accommodate your request.
* Category:
Enter a description of your business. This will be the information that we include about your site. We will accept a maximum of 50 words. Descriptions beyond that will be edited at our discretion. 
Description:

Private Contact Information
Your contact information below is required to process your request. It will be used for this purpose only and will not be displayed on our site.
* Name:
* Phone # (xxx) xxx-xxxx:
ex: (612) 555-1234
Email Address:


Advertising Options

Select the type of sponsorship you would like to have on our site.

* Advertising Option:
A1 - Bronze - Free
A2 - Silver ($75.00)
B1 - Bronze ($50.00)
B2 - Silver ($125.00)
C1 - Gold ($300.00)
C2 - Platinum ($375.00)
* I would like to add jayVT.com link to my website and receive $20.00 credit .: Yes
No
Deduct $20 if adding jayVt.com to your business website:
Order Total:
Amount to be processed:
$0.00
Special Instructions:
I was referred by::

Your submission indicates your acceptance of the website Terms and Conditions as posted on our website. Terms and Conditions may change from time to time. Your continued advertising on our site indicates your acceptance of the terms and conditions as they change.

* Terms of Conditions: I Accept the Terms & Conditions

* - denotes required field

 
Town of Jay Logo Link
Town of Jay Logo Link
Advertise on www.jayVT.com

 

 
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