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Company Name:
Contact Name:
Address:
City:
State:
Zip:
Phone Number:
Email Address:
Have you spoken with a Coffee County Shopper Account Executive Before?
Yes:
No:
If yes, who did you speak to?
Choose Your Ad Size:
1x1 - One Run - $9.75
1x1 - Two Runs - $8.75
1x2 - One Run - $19.00
1x2 - Two Runs - $17.00
1x3 - One Run - $28.25
1x3 - Two Runs - $25.25
2x2 - One Run - $37.50
2x2 - Two Runs - $33.50
2x2 - Front Page - $53.50
2x3 - One Run - $56.00
2x3 - Two Runs - $50.00
2x3 - Front Page - $80.00
2x4 - One Run - $74.50
2x4 - Two Runs - $66.50
Larger Sizes Available
please call.
Have you advertised with us before?
Yes
No
Name exactly as listed on the Credit Card.
Credit Card Number:
-
-
-
Security Code:
Expiration Date:
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/
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
I authorize The Coffee County Shopper to charge my credit card.
I state that all the above information is correct.
Information you want listed in the ad:
TotalGraphics, Inc. and the CoffeeCountyShopper.com do not accept responsibility for any classifieds that may be placed online or in the paper.