BUST PRODUCT SHOWCASE ORDER FORM

* Please upload the photo for your ad. The photo must be 1 1/4" wide and 1" tall, 300dpi, and saved as a tiff file. If you are unable to create a tiff file, a jpg of 375 pixels wide and 300 pixels tall, saved at the highest quality, will be accepted. Please name your file with your website address, followed by the appropriate file extension (such as www.mystore.com.tiff or www.mystore.com.jpg).

* Please enter a name for the product in the image you just uploaded. Product name can only be 18 characters or less, including spaces.

* Please enter the price of your product. Prices must be in US dollars, in the form xx.xx

* Please enter your web address (you can leave out the http://). Web addresses must be 29 characters or less.

* First Name

* Last Name

* Street Address

Address Line 2

* City

State

* Zip Code

* Country (Use USA for United States)

* Phone Number

* Email Address

*

1 BUST Product Showcase Ad in the April/May issue for $150.00

2 BUST Product Showcase Ads - April/May and June/July for $250

* Indicates Response Required