Promotional e-mail entry form        View sample coupons 

Your coupon, or informational Ad, will be emailed to over 375 Uintah Basin addresses.

(as of 7-01-04)

Please enter the following information to place your Ad.

I want this email sent out as a Coupon for only $15.00.

I want this email sent as a Promotional Ad for only $15.00.

Please run this Ad for free, we are a non-profit organization.

Run this ad and apply it towards my prepaid account.

Your Company /Organization Name

Approved By (Your Full Name, not published)

Address   (optional - published)

City    State   Zip Code

Phone Your Email address (not published)

Delete this text and enter your offer here... Coupon example: Buy one Get one Free... Or enter gift details or special offer... If an anouncement just enter the body of the text.

Delete this text and enter any limitations you have.. I.e. Not combinable * One gift per person...

Expiration Date of Coupon or end Date of Promotional Ad

Publish all the information I have entered except my name and email address. Change this statement the way you wish or leave it to accept as writen.

Please publish this Ad for the following email dates.

 9-15-04  10-16-04  11-15-04  12-15-04

  Coupon & promotional Ads are for local businesses only. We reserve the right to refuse any Ad for any reason. Submit your offer and we will invoice you later or apply toward your yearly purchased package.