Advertising Services Submission Form
ADVERTISING SUBMISSION FORM
Between Call Me Ozz Dot Net (Hereafter referred to as: CMO) and (Name of person agreeing to advertise)
Client Name:
AGREEMENT OF SERVICE
Title/Position:
Today's Date:
Name of Business: (Hereafter referred to as client)
Address:
City, State and Zip:
Business Phone Number:
Contacts Cell Phone:
E-Mail:
Web Link (If Applicable):
Is this part of or promoting an event? If yes, event name:
Please include exact date and time of the event
Is this, or does this include an “Enhanced Listing”?
-If yes, the Enhanced Listing Addendum must be attached.
Ad shall be placed in the following spots:
Page:
Page:
Page:
Slot #:
Slot #:
Slot #:
Slot #:
Slot #:
Slot #:
Slot #:
Slot #:
Slot #:
Page:
Page:
Page:
Page:
Page:
Page:
Rate:
Rate:
Rate:
Rate:
Rate:
Rate:
Will Call Me Ozz build the ad?
Note; if the client is sending a JPG ad it must be 600x873 for portrait or 900x527 for landscape.
Specific information for this advertisement?:
Your bill will include:
Paid By: Cash or check? If Check, what's the check number?
Additional Notes:
By electronic signing below, all parties agree to the terms set above, and payment confirms agreement of terms of service: (Text Boxes below)
By completing and submitting the form above, you are agreeing to Agreement of Service
Date
Date
Representative for CMO
Authorized Representative for Client
Gross Receipts Tax
Total Rate For Contract
Total Rate For All Ads Listed Above
Set Up Fee
DISCOUNT
Notice: CMO reserves the right to refuse any advertisement, promotion or event for any reason in the best interest of CMO
Check this box for the sales person to update their RESS Spreadsheet
Portrait or Landscape?
Ad start date:
Ad end date:
Rate:
Rate:
Rate:
Submitting a falsified form is fraud.
