Just print
this form, fill out your order and phone
in your order to 606-862-9692. Phone-in orders are accepted Monday through Friday from
9:00am to 4:00pm EST. Or, you may mail in your order to: Kolb Aircraft Co.,
590 Hal Rogers Dr., London, KY 40744
SHIP
TO
BILL
TO (Check here [ ] if same)
PHONES: (DAY)
(NIGHT)
Item
No.
Description
CHECK
ONE
AMOUNT
AD
001-3
Home Page Ad in
Position #1 for 3 months
$120.00
AD
001-6
Home Page Ad in
Position #1 for 6 months
$240.00
AD
001-12
Home Page Ad in
Position #1 for 12 months
$440.00
AD
002-3
Home Page Ad in
Position #2 for 3 months
$112.50
AD
002-6
Home Page Ad in
Position #2 for 6 months
$225.00
AD
002-12
Home Page Ad in
Position #2 for 12 months
$412.50
AD
003-3
Home Page Ad in
Position #3 for 3 months
$105.00
AD
003-6
Home Page Ad in
Position #3 for 6 months
$210.00
AD
003-12
Home Page Ad in
Position #3 for 12 months
$385.00
AD
COPY 1
Home Page Ad --
HTML Ad Design
$10.00
AD
COPY 2
Home Page Ad --
GIF or JPEG Ad Design
$75.00
AD
COPY 4
Home Page Ad Set
Up Fee for Shockwave or Flash
$15.00
TOTAL AMOUNT DUE
PAYMENT
METHOD: Enclosed is:
[ ] Cashier's Check [ ] Money Order [ ] Personal
Check
[ ]
VISA [ ] MasterCard [ ] Discover [ ]
American Express
Name on Card__________________________________________
Card Number __________________________________________
Expiration Date _____________________
