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Southeastern Antiquing and
Collecting Magazine
Antique Shop &
Mall Directory Mail/Fax Form
Package
1 - $45 per month for a 65-word listing in the Shop and Mall Directory. You receive 25 magazines, and your shop is listed in the magazine and on our website.
Package
2 - $35 per month for a 65-word listing in the Shop and Mall Directory. You receive 12 magazines, and your shop is listed in the magazine and on our website.
Package
3 - $25 per month, our rock-bottom deal, for a 65-word listing in the Shop and Mall Directory. You receive no magazines, but your shop is listed in the magazine and on our website.
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Name:_____________________________________________
Date:_______________________
Business
Name:______________________________________ Position:_____________________
Address:_________________________________________________________________________
City:______________________________
State:__________________ Zip:________________
Phone:__________________
Fax:___________________ E-mail:_______________________
Payment
Method: ( )Check (
)Money Order (
)Credit Card
Credit cards accepted: ( )Visa
( )Mastercard
Credit Card
#:____________________________________ Exp. Date:____________________
Please
choose the Antiquing in the Southeast Package desired:
( )Package 1 - $45 per month
( )Package 2 - $35 per month
( )Package 3 - $25 per month
PLACE YOUR
AD COPY IN THE BOXES BELOW UP TO 50 WORDS.
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Which months do you want your ad to appear?
| ( )January |
( )February |
( )March |
( )April |
( )May |
( )June |
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( )August |
( )September |
( )October |
( )November |
( )December |
Mail your completed
form to:
Southeastern
Antiquing
P.O. Box 510
Acworth, GA 30101
If you are paying by
credit card you may fax or e-mail us at:
If
you live outside of the United States, payment must be in U.S. Dollars and in the form of
a International Money Order, Credit Card, or Cash.
You may send CASH (U.S. Dollars) at your own risk. |
For your security please do not include your credit card information in the e-mail.
Please call our Toll Free # with your credit card information after you e-mail the form.
Toll Free: 1-888-388-7827
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