Classified Ad Request

Advertising Rates: Effective January 1, 2000
Non-Members - $40.00 Per Classified Ad - 1 Time/"The Arkansas Pharmacist" (Journal)
Members - No Charge

Name          Last    First      MI 
Please check title:  P.D.   Ph.D.  Pharm.D.  Other
Store Name     (pharmacy, hospital name, etc.)
Address      
City    State Zip 
Phone     Fax 

30 Words Maximum
Classified ads submitted for 'The Arkansas Pharmacist" will also be placed
on the APA website at no charge.
 

Please Check One:    Spring Issue-Street Date May 1     Summer Issue-Street Date Aug.1
                                 Fall Issue-Street Date Nov.1           Winter Issue-Street Date Feb.1       

PAYMENT METHOD

If paying by check, please print and mail this form to  APA, Classified Ads, 417 South Victory, Little Rock, AR 72201-2923) 
Check Payable to APA         Check Number

                                    (Please enter your credit card number below) 
Discover Card             Visa/MasterCard            American Express
             

Cardholder's Name        Expiration Date 

Total Amount Paid  

________________________________

OFFICE USE ONLY

Total Amount Received
Date Received 		  
 
Payment Method  Check     Credit Card     Cash

    

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Copyright © 2000 [Arkansas Pharmacists Association]. All rights reserved.
Revised: October 12, 2005 .