HearingLossWeb Advertising Listing Form

(Please use this document as a guide and email your submission to advertising@hearinglossweb.com. Or you may print this form, fill it out and mail it to the address at the bottom of the form.

Name: ______________________________________________________

Address: ______________________________________________________

City, State and Zip: _________________________________________________

Voice Phone: ______________________________________________________

TTY: ______________________________________________________

Fax: ______________________________________________________

email: ______________________________________________________

Website: ______________________________________________________

 

Hearing Loss and Professional Organization Memberships:

 

Organization Description (Describe your organization, its products and services. What do you want potential clients to know about you? What makes your product special or different?):

 

Website Link Placement (Select desired link location(s) from the Resource Directory Home Page and indicate here.)

 

Newsletter text ad (This short ad goes in our weekly email newsletter. Just grab readers' attention and give  them appropriate contact information - Max 8 lines, 65 characters per line):

 

Package cost $50 US
Additional links ($5 each) $____
Total cost $____


Return completed Listing Form with your check to:

Hearing Loss Web
5663 Balboa Ave. #357
San Diego, CA 92111-2705

Or, you may email the information to advertising@hearinglossweb.com and send separate payment.

Contact us!

Advertising Letter