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:__________________________


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