_____ I will reserve an ad in the CHAPTER CHATTER newsletter.

_____	Business card (3¾" x 2")
_____	Quarter Page (3¾" x 4½")
_____	Half Page (3¾" x 9½")
_____	Full Page (8½" x 10")
_____	Flyer Insert(8½" x 11")

The month(s) I prefer are (circle):


Issue:		Artwork Due:
Jan./Feb.		Dec. 15th
Mar./Apr.		Feb. 15th
May/June		April 15th
July/Aug.		June 15th
Sept./Oct.		August 15th
Nov./Dec.		October 15th

___ I would like to advertise on the HSMAI website:


___ Link (one year)
___ Enhanced Listing (one year)

_____ I will reserve an ad in the Yearbook & Directory:


_____ Quarter Page (3-3/4" x 4-1/2") B&W
_____ Quarter Page (3-3/4" x 4-1/2") 4-Color
_____ Half Page (3-3/4" x 9-1/2") B&W
_____ Half Page (3-3/4" x 9-1/2") 4-Color


___ I would like more information on sponsorship and/or raffle donation opportunities.

___ I would like more information on putting a company/business profile in the bi-monthly "Chapter Chatter" newsletter.

NAME: _______________________________________________________

COMPANY: ____________________________________________________

ADDRESS: ____________________________________________________

PHONE: ______________________________________________________

PAYMENT: ___ CHECK ___ VISA ___ MASTERCARD ___ AMERICAN EXPRESS

CARD # __________________________________ EXP _______________

SIGNATURE: __________________________________________________