Smoke Free Advertising Order Form
Business Name
Contact Name
Address
City
State
Zip
E-Mail
Phone - numbers only 1115553232
Fax - numbers only 1115553232
Web Site Address
I certify that my Accommodations are
100% Non-Smoking Property
Guaranteed Smoke-Free Rooms
Type of Accommodation
Hotel
Motel
Inn
Bed & Breakfast
Condo
Cabins
Resort
Resort Homes
I am ordering the following type of Ad
Disply Ad - $ 295.00
Economy Ad - $195.00
Line/Link Ad - $95.00
Display Ad - 2 night trade
Display Ad - 4 night trade
Economy Ad - 1 night trade
Economy Ad - 2 night trade
Line Ad - 1 nght trade
Optional Monthly highlight Ads
One Month Hi-lite State Page - $95
One Month Hi-Lite Main Page - $195
State page Trade Option - 1 night
Main page Trade Option - 2 nights
Content for Display Ad
Authorized Signature
Date of Agreement - (01/01/2007)
I will pay for my ad as indicated
PayPal - use pay now button
Gift Certificate Trade