Tae Kwon Do Journal
(On-Line Advertisement Submission Form)

Tae Kwon Do Journal
P.O. Box 281,   Grand Blanc,   MI   48480   USA

This On-Line Advertisement Submission Form
is for those paying by CREDIT CARD ONLY!

Complete the form below and then click "Submit Application" at the bottom of this page.

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Street Address:
Postal Code:
E-Mail Address
Ad Type And Location:
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You must attach a your ad fille in a .jpg or gif format, no larger than 110K.

Dates of Insertion
(All ads begin on the first of each month)

First Month Ad Is To Run:    
Last Month Ad Is To Run:    
If you wish your Ad to appear in a specific article, type the title of the article in below in the area provided. If the space is unavalable we will contact you..
Title Of Specific Article:

Credit Card Holder Information

Name (As it appears on Card):
Street Address:
Zip Code:
Phone: (Required
E-Mail Address (Required)

Credit Card Information

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    Credit Card:     Exp. Date: Month     Expires (Year):

Agree To Terms and Condition Of Advertisement
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