Web Advertising Agreement

I would like to advertise on azmpi.org. The months I prefer (please circle at least three): Enclosed is my payment of $ _____________________

Printed Name: _______________________________________________________

Company: __________________________________________________________

Phone: __(____)_______________________Email: _________________________

(Circle One) Payment by Check/American Express/Visa/MasterCard

Card # _____________________________ Expiration Date: _________

Signature: _________________________________________________

Please return completed form with signature, and full payment to:
MPI Arizona Sunbelt Chapter
P.O. Box 40096
Phoenix, AZ 85067-0096

Fax: 602-240-5553

Please email banner ad to:
jwinter@azmpi.org

Advertising will not be placed on the website without receipt of completed agreement and full payment.