Advertising Request Form

To advertise on our website, please fill out the form below. Once we get it, we will review your request and contact you to make arrangements. Please be sure to provide a correct phone number and e-mail address.

We will not bill you until we have contacted you and confirmed arrangements. Also, all page requests are honored on a first come, first serve basis. If a page you request is not immediately available, then we will suggest an alternative page or put you on a waiting list.

For more information on billing, please see our advertising policies.

Business Information

Business Name:

Address:
Address:
City:
State:
Zipcode:

Website:

Contact Information

Contact Person's Name:

Contact Address:
Address:
City:
State:
Zipcode:

Contact Phone:
Contact E-mail:

Advertisement Request

On which pages do you wish to advertise:

Page Name	URL	Price/Month
Home Page	URL	$25
Links Home Page	http://www.ebonypride.org/links	$10
Sponsors Home Page	http://www.ebonypride.org/sponsors	$10
Join Us Home Page	http://www.ebonypride.org/join	$10
Festival Home Page	http://www.ebonypride.org/festival	$10

Additional instructions/comments: