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Pet Afflaire Program Ads
Pet Afflaire Event Program Order Form
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*
" indicates required fields
I want to purchase an ad for the 2023 Pet Afflaire program.
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$115 Full Page Ad (5.25" wide x 10" tall)
$75 Half Page Ad (5.25" wide x 4.75" tall)
Will You Supply Your Own Ad Design?
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Yes, I will email you my ad design
No, I will need you to design an ad for me
Submitting Artwork - Whether you are submitting your own ad or providing us with logos, images or components you want included as we design it, please email all items to JJ Garringer at jgarringer@hsdayton.org or you can submit instructions below.
Company Name (if applicable)
Name
*
First
Last
Email
*
Phone
Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
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New Hampshire
New Jersey
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New York
North Carolina
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Northern Mariana Islands
Ohio
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Puerto Rico
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South Carolina
South Dakota
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Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Payment method
*
Credit card
PayPal
Credit Card
*
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
Security Code
Cardholder Name
To use PayPal, click Submit and PayPal information can be entered.
Phone
This field is for validation purposes and should be left unchanged.
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