
I wish to reserve advertising space as indicated below: _____ Gold Page (8 1/2 x 5 1/2) $250 _____ White Page (8 1/2 x 5 1/2) $150 _____ Half Page (4 1/4 x 5 1/2) $80 _____ Quarter Page (2 3/4 x 5 1/2) $50 _____ Booster (One Line) $25 Name:___________________________________________________ Title:__________________________________________________ Company:________________________________________________ Address:__________________________________Zip:__________ Telephone_______________________________________________ Authorized Signature:________________$______________________ Print Copy Below or attach camera ready Black & white copy
---------------------------------------------------------- ---------------------------------------------------------- For more information call 718-271-6663Made check payable to: PFLAG QUEENS CHAPTER Please send this contract with your payment to: PFLAG QUEENS CHAPTER PO BOX 751043 FLUSHING, NY 11375-1043 DEADLINE: January 30, 2012