or
FAX to (818)
224-3217 A representative from the ODL will contact you regarding how to deliver
your banner ad graphics.
I certify that the above information is true, correct and complete
to the best of my knowledge. I authorize the ODL to verify the
above information.
I hereby submit my application
for a banner ad placement on the ODL Website.
FIRST
NAME:
LAST
NAME:
ADDRESS:
CITY:
STATE:
ZIP CODE:
COMPANY:
PHONE:
(___)
FAX:
(___)
EMAIL:
WEB
SITE ADDRESS: http://
HOW DID
YOU HEAR ABOUT THE ODL Website?
SIZE
OF AD:
Banner 468 x 60
Banner 125 x 125 Square Button
Banner 120 x 240 Vertical Banner
Banner 120 x 60 Button 2
Banner 120 x 90 Button 1
Banner 88 x 31 Micro Button
Please Enter Your Start Date for
AD:
PAYMENT TYPE (please circle):
CREDIT CARD INFORMATION:
TYPE
OF CARD (please circle):
CREDIT
CARD NUMBER:
CREDIT
CARD EXPIRATION DATE:
NAME
ON CREDIT CARD :
Submit this application along with your payment to the following
address:
24760 W. Via Del Llano
Calabasas, CA 91302____________________________________ ________________________
(Applicant Signature) (Date)
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