REQUEST
REPRESENTATIVE
ONCE YOU HAVE SPOKEN WITH AN AD REPRESENTATIVE
FILL OUT THE INVOICE INFO AND MAIL TO IMPACT WITH YOUR PAYMENT.
ADVERTISER:__________________________________
CONTACT NAME:______________________________
ADDRESS:_____________________________________
CITY:__________________________STATE:_________
COUNTRY:_________________MAILSTOP:_________
PHONE NUMBER:(____)_________-_______________
ADVERTISING REFERENCE NUMBER:
_______________________________________
IMPACT CONSULTANT NAME:
_______________________________________
Check here if Internet Advertising is included.
_______________________________________
Signature of acceptance to pay
Mail Your Payments & Layout to:
Impact Multimedia Publishing
4100 17th Street #1
San Francisco, Ca 94114
adobeinstructor@indifference.com
Thank you for advertising with impact.