Advertiser Contact Name

Address

City State Zip

Phone Fax email

I would like to place an ad I would like to insert a flyer (no flyers will be inserted into the Septeber/October issue.)

Ad size (ad sizes are located on previous page) Horizontal Vertical

Rate Total # of insertions First month of insertion

List Months of Insertion Jan Feb Mar Apr May Jun Jul Aug Sep/Oct* Nov Dec *Please Note: The ad cost of the September/October Annual Convention & Mega Trade Show Double Issue Publication will be slightly higher. The advertiser is responsible for payment, of any ad(s)/flyer(s) placed in thsi publication. All terms and conditions listed on the Advertising Requirements & Rates page are essential parts of the is agreement.

Signature Date

Please Mail or Fax Advertising Insertion Order Form to

WMDA
1532 Pointer Ridge Place, Suite G
Bowie, MD 20716

Fax: 301-390-3161