Pocket Perfect Order Form

A Pocket Perfect Yellow Pages
ORDER FORM
www.appyp.com

Business Name of Banner Advertiser:

Advertising Zipcode:

0/5 characters

Select Below:

$159 (one-time fee) Lifetime Index Banner in this zipcode.

Please publish in all USA portals at no additional charge.

YES

Please publish the same banner in all INT (International) portals at no additional charge.

YES

Decision Makers Title:

Phone Number

First Name:

Last Name

Street Address

Address Line 2

City

State

Zip Code

Email Address

Provide website links and other information for composition of your banner here:

* Name on Card

* Credit Card Type

* Credit Card Number

* Expiration Date (mm/yy)

Provide website links and other information for composition of your banner here:

Send one-time payment of $159.00 (U.S.) to: A Pocket Perfect Yellow Pages at
908 Ashurst Ct. Hendeson, NV 89011. E-mail website links for images and/or banner
for sizing and proofs upon payment. Banner dimensions are 251x270 with up to 3
frames. Banner proofs will be e-mailed to the decision maker and approved prior
to posting. E-mail us with any questions you might have at: PocketPerfect@yahoo.com

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