BAITNET.COM GLOBAL AD BOX ORDER FORM

1
BAITNET.COM GLOBAL AD BOX ORDER FORM Please
choose from one of the following three options
for your ad box on our web site. Please circle
only one option 1) 100,000 global views -
60 2) 200,000 global views - 100 we will
notify you when your ad gets down to 5,000 views
left 3) 500,000 global views - 200 If you
want BaitNet.com to make an image for your ad
box, put an X in this box If you would like
to send us your own image, 90 pixels tall by 130
pixels wide, and less than 15kb, put an X in
this box According to the option you have
selected above, please send a check or money
order in the proper amount, US funds only,
to Andy Bartels BaitNet.com P.O. Box 324 La
Crosse, WI 54602-0324 Also, please fill out the
form below to receive your free enhanced database
listing. Please fill out the form below
completely and accurately! We will send you
an itemized receipt by mail that lists your
service period dates. Owner/Manager
Name (your name will not appear on the website)
_________________________________ Business name
__________________________________________________
________________________ Address
__________________________________________________
_____________________________ City
________________________________________ State
___________ Zip ____________ County
__________________________ Telephone (include
area code) (_____)__________________________ To
ll free number (_____)_______________________ Fa
x number (_____)_________________________ E-mai
l address _______________________________________
__________________________________________________
____ Internet address _________________________
__________________________________________________
_________________ Regular hours ______________
Dates ___________________________________________
___________________________ Special
hours1 ______________ Dates ____________________
__________________________________________________
Do you sell licenses (Y/N)? ____ Do you
sell convenience items (Y/N)? _____ Miles
to gas nearest station? _____ Nearby waters -
names ___________________________________________
_____________________________________________ __
__________________________________________________
__________________________________________________
_____ Primary fish species nearby
__________________________________________________
__________________________________ Sell live
bait (Y/N)? ____ Bait selection_________________
__________________________________________________
_______ ________________________________________
__________________________________________________
_________________ Sell tackle (Y/N)? ____
Tackle selection ________________________________
_______________________________________ ________
__________________________________________________
_________________________________________________