Program Advertising

1. First Name: *
2. First Name: *
3. Company: *
4. Telephone: *
5. Email: *
6. Ad Positioning & Pricing: *
   $1,950.00 Inside Front Cover (Left)
   $3,200.00 Outside Back Cover
   $2,000.00 Full Page Spread 15" x 10"
   $1,950.00 Inside Front Cover (Right)
   $1,600.00 Inside Back Cover
   $1,200.00 Full Page Interior 7" x 10"
   $1,195.00 1/2 Page Spread 15" x 5"
   $900.00 Half Page 7" x 5"
   $700.00 Quarter Page 3.5" X 5"
   
7. 1. Card Type: * American Express Discover MasterCard VISA
   2. Name on card: *
   3. Card Number: *
   4. Exp. Date: * 01 - Jan 02 - Feb 03 - Mar 04 - Apr 05 - May 06 - Jun 07 - Jul 08 - Aug 09 - Sep 10 - Oct 11 - Nov 12 - Dec / 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040
8. Your Web Address *

CANCELLATION AND WITHDRAWAL: Any applicant who cancels/withdraws the contract for Sponsoring, Advertising, and/or Marketing Enhancements with The Gulf Coast Conference after application has been submitted must do so in writing within 24 hrs of submission by emailing The Gulf Coast Conference at ametcalf@gulfcoastconference.com of your intentions in order to receive a full refund. Failure to do so within a 24 hr period will result in payment being retained by The Gulf Coast Conference and applied in whole satisfaction.

1.  *  Please indicate that you have read and agree to the Terms and Conditions, Cancellation Policy and Privacy Policy.