Advertising Order Form *This information will appear in the ad. Return to Home Page
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Bulk Water Delivery Supplier Directoryfor the United StatesMake Check Payable to: Tribute MarketingMail to: Tribute Mktg. Box 802, Attleboro, MA 02703 |
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*Company |
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Contact Name |
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| *Address | |||||||||||||||||
| *City, ST, Zip | |||||||||||||||||
| *Telephone | |||||||||||||||||
| Fax | |||||||||||||||||
| *Truck and/or tank capacities |
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*Types of Water Service (Industrial wastewater tankers not permitted. Potable, pool, only.) |
___ Potable ___ Swimming Pool ___ Sea ___ Tank Rentals ___ Emergency/Disaster Relief ___ Landscaping or Compaction |
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| *Geographic Service Areas: | |||||||||||||||||
| *Additional information | Your potable water state license # | ||||||||||||||||
| *Your Web Site Address (if any): | www. | ||||||||||||||||
| If you do not have a web site ... |
Would you like to receive a quote? __Yes __No |
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Advertising Service Requested
Total Payment Amount
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___ Text Listing $10/Month @ ___ Months
___ Banner Ad $15/Month @ ___ Months ___ Banner Ad $180/Year (see web site for terms) __ I will need a Free Banner Ad/Image Designed __ I will email artwork to: info@bulkwaterdelivery.com __ 1 Year Top-Position Locked-In for my state (if available) |
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| Method of Payment | ___ Check/Money Order ___ Credit Card | ||||||||||||||||
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Select Card Type: ___MC __VISA |
Expires ___________ 3-digit Sec. Code __ __ __ |
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| Billing Address for Credit Card if different from above address | |||||||||||||||||
| Desired Date to Begin Running Ad? |
