Dream Network Journal Advertising Contract
Please Print Out and send completed form, Ad Copy and payment to
Dream Network, PO Box 1026, Moab, UT 84532
(435) 259-5936 email: Publisher@DreamNetwork.net

Date    _____________   Contact Person    ____________________________

Company Name    _________________________________________________

Address    ________________________________________________________

City/State/Zip    __________________________________________________

Phone    ___________       Fax    ________________  Email    ________________

Ad Size and Dimensions    ________________________________________

Frequency (# of Times Ad to Appear in Consecutive Issues)    ________
                                                                   (Special! 10% Off/Two Consecutive Issues; 20% Off/One Year, Four Issues)

Dates or Volume and Issue Numbers    ____________________________

Base Cost Per Ad __________   Special Positioning (+15%)  ____________
                                                         (Available only for 1/3 size or larger.)

I understand that by signing below I am making a firm commitment for advertising space
in the specific issues listed. I will provide payment and camera ready art in accordance
with the specifications and deadlines and abide by the conditions stated
in Dream Network’s Display Advertising Rate Brochure.

_____________________________________________________________________________
Signature of Advertiser                                                                                          Date
If paying with credit card  *  We accept Visa, MC & AmEx *

Card Type:__________________  Card #:_________________________________________

Expiration Date______________  Card Holder Signature:__________________________

(PLEASE DO NOT WRITE BELOW; DREAM NETWORK USE ONLY)

AMT RECV’D $_____  BALANCE $_______   DATE  ______ ISSUE(S) ______
DATE ART RECV’D ______  ART STATUS_______ DCSA_______  INITIALS______

1337 Powerhouse Lane, Suite 22 * PO Box 1026, Moab, Utah 84532
  Phone (435) 259-5936  *email: Publisher@DreamNetwork.net
 Website:  http://DreamNetwork.net