Classified Advertising Online Insertion Order Form

Please enter your information using the form below. This insertion order is for a print advertisement that will appear in the classified section of FacilityCare magazine. To see ad rates and packages, please click here. Once this form has been completely filled out and submitted, Amy Lehr, our Classified Sales Representative, will contact you to confirm the insertion. You will also receive a fax confirmation proof of the ad's design prior to the ad being placed in the magazine. If you have any further questions, please do not hesitate to contact Amy Lehr at (804) 762-9600 x 212 or via email at alehr@douglaspublications.com.

*Denotes a required field.

*Company Name:
*Contact Name:
*Address:
*City:
*State:
*Zip:
*Phone:
Fax:
*Email:
Web Site:
Please select the size for your classified ad below.
*Size:
Please type the heading for your classified ad below.
*Heading:
Please select the start and ending date for your ad.
*Ad Start Issue/Year:
*Ad End Issue/Year:
Please carefully enter the text copy for your ad in the space provided below. You will receive a fax confirmation proof of your ad prior to each insertion. This will give you the opportunity to modify the ad's design prior to each insertion.
*Ad Copy:
Amy Lehr , our Classified Sales Representative, will contact you to review your request and confirm your insertion.

 


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