Classified Ad Form

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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:   Visa/MC
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
 

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