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Place AD Form in Word Place AD Form in PDF
Please provide the following contact information for Northland Advertising LLC:
(*These fields must be filled out and correct. Submissions for ads and postings with incorrect or missing contact information will NOT be POSTED)
Name * Title Organization Street Address * Address (cont.) City * State/Province * Zip/Postal Code * Country * Work Phone * Home Phone * FAX E-mail * URL
Coupon\Promo Code
Independent Representative ID#
Choose one of the following options (examples of Ads):
Home Page and City ADs- 1 AD for 1 year , two(2) free ad changes, additional changes will be charged at $20 per change.
Home Page AD- List of Websites for Home page ads
City AD List of Websites for City ads
1. Enter the Northland Advertising LLC website that you would like to place your ad on:
2. Home Page AD OR City Page Ad
Home Page AD City Page AD
3. Options for ad Placement
INTRO POSTCARD OFFER $99 Home Page ad 1 Year - Nonrenewable price Intro Regular Price without postcard ad $149.00 INTRODUCTORY OFFER $49 City Page ad 1 Year - Nonrenewable price
4. Choose this option only if you choosing a state then city ad (Home page ads will be posted on the Home Page)
Choose the state or Country for thead
AL AK AZ AS CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Canada or Country CANADA United Kingdom New Zealand
Enter the name of City for ad. (If your city is not listed we will add it).
Would you like a your logo placed in the ad?
Yes- I would like a logo in my ad No - I do not have a logo for the ad
*Example Ad/Information*
I agree to the Terms of Service and Privacy Policy
I disagree to the Terms of Service and Privacy Policy ( If you choose this option your ad will not be placed