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Please fill out the information below. (The RED Items are required)

Contract #:
Advertiser:
Advertiser's Representative:
Type of Business:
Address:
City:                               State:                          Zip:
Phone:                                                            Fax:
( )-      ( )-
 
 
Ad Size
Full Page 2/3 Page 1/2 Page 1/3 Page
1/4 Page 1/6 Page 1/12 Page  
Description:
Vertical Horizontal    
Four Color Black & White Other
Terms Date :
Starting with issue
Ending with issue
Special Instructions*:
# of Ad Insertions:
Cost per Insertion:
Color Charge:
Production Charge(s):
Amount in Trade:
Total Contact:
$
 
 
*PayPal Payment
 
 
 
 
Please make payment by Check or wire transfer or PayPal in the name of “Las Vegas Hollywood” or in the name of our “Official Agency Representative” after this contract is signed and approved by both Parties.
 
I hereby warrant that I have read the Contract Terms & Conditions as spelled out and that I have full power and authority to sign for the above named firm.
 
Advertiser's Representative Name:
Title:                               Date:                         
Email:
Las Vegas-Hollywood Rep:
Date:
 
 
 
 
Las Vegas-Hollywood Magazine
Attn: Advertising Dept.
P.O. Box 15187
Las Vegas, NV 89114
info@lasvegashollywood.com
www.lasvegashollywood.com



Inquiries of additional information:

Las Vegas
Ph: (702) 562-3333
Fax (702) 562-3333

Hollywood - Beverly Hills
Ph: (310) 613-2773
Fax (702) 562-3333

 

 

 

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