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Healthy & Green Living Directory Reservation Form
This agreement form is for existing advertisers and one-month annual directory advertisers only. If you are signing on for a new multi-month contract, please request our regular ad agreement form.
Please complete this form in it's entirety to reserve your space in the annual directory. THIS IS JUST A RESERVATION FORM. The content of your listings will be submitted on our website and we will contact you about the details of your ad and/or business profile.
Do not hesitate to contact us with any questions you have. We are happy to help! Call 251-990-9552 or email publisher@healthylivinghealthyplanet.com.
Contact Information
This info will be used by Natural Awakenings staff to contact you. We will NOT use this information in your listing or ad. Please provide best contact information for us to reach you should we have questions concerning your listing and/or ad.
Name
*
First
Last
Business Name
Mailing Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Phone
*
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Email
*
Confirm
DIRECTORY AD PACKAGES
Complete this section if you wish to purchase an ad package in our directory issue. A display ad, business profile and 3 directory listings are included in the price.
Select the Size of Your Ad (this determines the price of your package)
1/4 Page Color Ad ($500)
1/3 Page Color Ad ($600)
1/2 Page Color Ad ($700)
Full Page Color Ad ($1000)
Outside Back Cover ($1400)
Full Page on Page 3 ($1300)
Inside Front Cover ($1200)
1/2 Page on Table of Contents ($800)
All rates are for color ads.
Business Profile
I would like to take advantage of my free business profile.
I do not wish to have a business profile.
Ad Design Fees
I'll provide camera-ready artwork
1/4-1/3 Page Ads ($50)
1/2-Full Page Ads ($75)
Design my ad for free! (available for early birds BEFORE DECEMBER 2nd ONLY)
AD PACKAGE TOTAL
$
Dollars
.
Cents
Cost of your package, determined by your ad size.
DIRECTORY LISTINGS
This section is to reserve your listing spots in the annual directory of the February issue. If you are purchasing an ad package, DO NOT fill out this section (only fill out the Ad Package section above).
Pricing:
1 listing for $99
$49 for each additional listing
Early Bird Special:
Get a bonus listing for free when you reserve by December 1st!
How many listings would you like?
1 for $99
2 for $148
3 for $197
4 for $246
5 for $295
DIRECTORY LISTINGS TOTAL
$
Dollars
.
Cents
Total for all of your listings. See pricing above.
BUSINESS PROFILES
This section is to reserve your business profile spot in the annual directory of the February issue. If you are purchasing an ad package, DO NOT fill out this section (only fill out the Ad Package section above).
Please select the option that applies to you:
Which profile price do you qualify for?
$225 with purchase of directory listing
$275 a la carte
PROFILE TOTAL
$
Dollars
.
Cents
Cost of your profile. See pricing above.
TOTAL AMOUNT DUE NOW
*
$
Dollars
.
Cents
Package Advertisers: Enter the cost of your ad package.
Other Advertisers: Add up the totals for the directory listing and profile sections to determine the amount due.
Digital signature
*
I certifiy that I am an authorized representative of the company shown, I agree to the terms and conditions specified on this contract, and I understand the deadlines and payment policies.
Payment can be made by PayPal, calling in a credit/debit card or mailing a check. Payment must be received by January 12, 2021 to guarantee the placement of my listing and/or ad in the annual directory issue. Payment must be received by December 4, 2020 to receive Early Bird offers.
(Once this form is submitted, Natural Awakenings will contact you to make sure you understand what needs to be submitted for your listings, ad and/or profile.)
Today's Date
*
MM
/
DD
/
YYYY
Preferred Method of Payment
*
Pay online via PayPal. Go to www.paypal.me/nagulfcoast to submit payment.
Pay online via PayPal. Please send me a PayPal invoice.
Call in credit/debit card number. I will call Natural Awakenings at 251-990-9552 to make my payment.
Mail in a check
I'm an existing advertiser. Please add the amount due to my regular February ad credit card charge.
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