Bank notes - Classified Ad Form

Your Name:
E-Mail:

The following information will appear in your classified ad:

Select type of ad:

Classified Ad for 3 months($5)

Classified Ad for 6 months($8)

Classified Ad for 12 months($10)

Bold text ad ($1 extra)

Underlined text ad ($1 extra)

Coloured text ad ($1 extra) (choose: blue or red)

Uppercase text ad ($1 extra)

Ad includes image ($5 extra for 3 to 12 months for an image of up to 30kb in size)

Total payment for an Ad:

U.S. funds

Payment instructions:

Please contact us if you wish to pay with money order or cheque (check).

Prefer paying with Paypal?

Click on the image:

Type of Merchandise:

Your Ad Title:

Text of Your Ad:

Maximum 10 lines per ad

Contact Information:

Your Name, Address, Phone Number, Fax Number, E-Mail address

I state and agree that:

I have submitted my payment. I understand and agree that my ad will be posted at
http://www.banknotes.com/ads.htm upon receipt of my payment by webmaster of this website.

Press "Submit Form" Only Once