Advertising Order Form     *This information will appear in the ad.        Return to Home Page

USA Directory of Bulk Water Pool Water Delivery Services Suppliers by State

Make Check Payable to: Tribute Marketing

 

Mail to: Tribute Mktg. Box 593, Wakefield, RI 02880

 

Paying by Credit Card? Fill in & Fax form to: 401-415-0088

*Company                 

  Contact Person

 
*Address, City, State, Zip  
*Telephone  
*E-Mail
*Truck and/or tank capacities

*Types of Water Delivered

(Industrial wastewater tankers not permitted. Potable, pool, ocean, only.)

Potable Water Haulers must use dedicated stainless steel tanks and be state certified.

__   Potable/Drinking     __ Swimming Pool                      __ Ocean

__   Tank Rentals            __ Emergency/Disaster Relief

__   Landscaping or Compaction   Other __________________

*Service Area (County, nearby cities)
  Additional information Your potable water state license #_________________
*Your Web Site Address (if any):
If you do not have a web site, we can create a modest, mobile-device friendly 1-3 page mini site. Yours to keep. Host anywhere.

Would you like to use our promotional $195 offer?   __Yes   __No

Advertise in State of ____

Total Payment Authorized: $_______

 

___ Yes, give me a 10% Discount for a 2 Year Ad or for multiple ads

__ Text Listing, $120/Yr. TopLocked under banner/order of 1st paid

__ Banner Ad,   $180/Yr. See publishing policy.

__ 10% DISCOUNT FOR 2 YEAR TERM, OR MULTI-STATE ADS

__ Side-Bar Ad $  60/Yr  Positioned in order of 1st paid; for bulk

      water related services by non-haulers; qty. ads as space allows

  __  I will need a Free Banner Ad/Image Designed

 __  I will email artwork to: info @bulkwaterdelivery.com

Method of Payment ___ Check/Money Order       ___ Credit Card

Select Card Type:  

    ___  DISCOVER    ___MC        __VISA  

Merchant Appearing on your card statement: "TRIBUTEMKTG"

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Expires ___________    3-digit Sec. Code __ __ __

  * AUTHORIZED SIGNATURE
  (Required for Credit Card Payments)
x
The mailing address for this Credit Card, if different from above address.
(FOR YOUR SAFETY, NEVER EMAIL YOUR CREDIT CARD INFORMATION)

_________________________________________________________

_________________________________________________________
Desired Date to Begin Running Ad?  TERM
From __________________ to _________________
Questions: Call 847-461-1944

email artwork to: info@bulkwaterdelivery.com
The quickest way to get your ad published within 24 hours is to call us. We'll get you listed, and send you an invoice which can be paid online or over the phone via credit card, or by mailed paper check. Email any artwork you want us to use, otherwise we'll design one for free for your approval.
Form updated: January 1, 2016