Marketplace Advertisement Submission

If sending a PDF or logo please email separately to URISA (different rates apply).

First, Last Name:
Credentials:
Job Title:
Organization:
Address:

City, State, Zip
Country:
Phone:
Fax:
Email:
Membership:	Member # ($200)
	Non-Member ($250)
Ad Job Title:

Description:(300 Word Limit)

Please include contact information for applicant along with a website, if available.

NEW! Featured Ad of the Month $100: your ad will be inserted into our URISA Digest for an entire month.

EFFECTIVE IMMEDIATELY: Payment is preferred when ad is submitted. We understand that this is not always possible. If payment is not possible at time of submittal we will need a credit card number to secure the ad position as well as payment for posting the ad. You must choose one of the options below:

Required

Method Of Payment

(in US Funds, drawn on a US bank)

type of card:
name as it appears on card:
card number:
expiration date:
please select:	corportate card -or- personalcard

PO #	(for your accounts payable use only, we do not accept PO's as a form of payment)

Note: Posting turn-around time is 1-2 days. Please contact URISAwith any questions or concerns.