Your Name? *
GTHS member? Yes No *
Personal or business? *
Category select one Books/ Printed Materials Computer Hardware/ Software Clothing Genealogy Lodging Personal Services Teaching Travel *
Today's Date Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , 2003 *
Ad wording * (limit 200 words)
URL of your home page Do you want to display your street address and telephone number in your ad? Yes No
Ad expriration date Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , 2003 *
Your E mail * Your Phone # *
Method of payment? Choose One Master Card Visa Check Cash NA *
CC Card Number Expiration Month / YR
Your ad will be run as soon as payment is received. You are responsible for proofing the ad contents. All ads must be suitable for all ages at the discretion of the director.
form designed July 25, 2002 GTHS