Application for Advertising with Departing Decisions COMPANY INFORMATIONCompany NameName First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Website ADVERTISING CATEGORIESMark the primary category to display your advertisement. Advertising in additional categories is possible for an additional advertising fee.Bereavement Discounts / OffersCelebrant / OfficiateCemeteriesChurches & Religious SupportCounselors & SupportEstate Attourney / PlanningEstate SalesFinancial PlannerFuneral / Cremation ServicesGreen BurialHome FuneralsHospice / Palliative CareIn-Home Care ServicesLife InsuranceLong Term Care InsuranceMedical ResourcesOrgan DonationRelocation ServicesRemembrance ProductsStory Telling / Historians / VideoSupport ServicesOther: Specify BelowOther Advertising Opportunities: 1 YEAR - 2 ISSUES (April & October)Mark the advertisement size(s) you would like to use.* Full Page Print Ad, 1 YEAR. 4.25" wide x 7.75" high $3,299.00 Half Page Print Ad, 1 YEAR. 4.25" wide x 3.75" high $2,299.00 Quarter Page Ad, 1 YEAR. 4.25" wide x 1.75" high $1,499.00 Additional Opportunity - Web Listing (Special Price When Purchasing Print) $325.00 Advertisement Design & Creation (For Print) $100.00 Online Listing Only (Logo, Company Description and Link To Your Site) $525.00 Terms And ConditionsGENERAL • Ad copy is the sole responsibility of the advertiser and will not be copy edited by Departing Decisions. • The ad from the most recent insert will run if new copy is not received by the deadline date. If there is no previous insertion, the space will be reallocated at the discretion of the editor and the advertiser will be liable for the cost of the contracted space. • Rates are subject to change with a 30-day notice. • Advertisers must sign a contract before an advertisement can be placed. Unsigned contracts will not be accepted. • Publisher reserves the right to approve or disapprove of all ads at its discretion. The publisher reserves the right to reject or cancel any advertising at any time. • The advertiser or advertising agency assumes liability for all content and claims made as a result of the ad. PAYMENTS • Payment can be made via check, VISA or MasterCard and to be paid in full upon signing contract, unless otherwise agreed upon. CANCELLATIONS • Cancellation (as well as changes in reservation orders) by an advertiser or its agency may not be accepted by the publisher after the issue reservation date. ADVERTISING REQUIREMENTS • Artwork or completed ads must be submitted in one of the following formats; jpeg, tiff, eps or pdf. • Pdf files must be distilled at the highest quality settings; no image or text compression, CMYK mode and all fonts embedded. • All images must be at least 300 dpi. Agreement* I agree to the above terms and have verified that all information provided is correct to the best of my knowledge. Name* By filling your name above you are certifying that you are authorized to make decisions for your company, and are agreeing to allow Departing Decisions to consider this your electronic signature.