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Name - First / Last *
Mailing Address *
Mailing City / Town *
Mailing State / Zip Code *
Email Address
Contact Telephone Number *
I would Like to Advertise on Island Pond Dot Com
I would like to place an ad on your Amenities section ($10.00 per year) *
I would like to place a banner ad on your web site Plus an ad in your Amenities section ($35.00 per year) *
I would like to place a banner ad on your web site Plus an ad in your Amenities section and make us a one page sub-web site. ($50.00 per year) *
Description of your ad (200 words or less) *
Web Site URL (www.yoursite.com) If you have one
Email Address (to be used in ad) If you have one
Phone Number (contact number to be used in ad)
Street Address (location of business for ad) *
City / Town of Business *
State / Zip Code (for use in ad) *
Contact Name (for use in ad, IE: Mary / Joe Doe) *
Fax Number (to be used in ad) If yo have one

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Clyde River Outfitters Island Pond, VT.

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