Advertise on Wayne "The Mango Man" Pickering's weekly e-zine
Full Name
Company
Address
City, State, Zip Code
Phone
Email Address
 
Credit Card Information (if applicable)
Name as it appears on Credit Card
Credit Card
Credit Card Number
Expiration Month/Yearex. 06/2012
 
Check below for your selected method of sponsorship:
[ ] Classified Ad(s) at $55.00 a line (three line minimum)
[ ] I would like a FREE ad. Included is payment for 3 ads (or to run the same ad 3 times) at $55.00 per line.
    I understand the 4th ad is FREE.
[ ] Special Insert:
Subject Line for Special Insert:
Type your 65 character/line advertisement(s) below:

Fax the completed Order Form to: 772-382-8487

Or Mail the completed Order Form to:
The Center for Nutrition & Life Management, Inc.
1 Glowing Health Way
Box 26-3030
Daytona Beach, FL 32126-3030