RVclassified, Inc.

Request to open a
DEALER ADVERTISING ACCOUNT




The following information will be used in opening your Dealer Advertising account. All requested information preceeded by ** must be provided.



               ** DEALERSHIP NAME: 
           ** YOUR NAME / Contact: 
                ** STREET ADDRESS: 
 CITY ** Dealership is located in: 
STATE ** Dealership is located in: 
                     ** ZIP CODE:  
                      ** PHONE NO:  Note: This Phone No. will be shown on all individual vehicle ads.
            TOLL FREE PHONE NO:  Note: This Phone No. will also be shown on all individual vehicle ads.
                 EMAIL ADDRESS:  Note This email address will be shown
                                                           on all individual vehicle ads.
            URL of your existing 
   web page/site, if available:

RVclassified places your company banner at the top of each of your individual For Sale ad display pages. If you currently have a banner you would like us to use enter in the box below the URL address where a copy of the banner may be found on the Internet. If you do not currently have a banner you feel would be appropriate for this purpose, RVclassified will prepare a static banner (non-animated) for you at no charge. Please provide below any special information you would like placed on your banner and/or any other additional information you would like RVclassified to be aware of.



PAYMENT METHOD


PLEASE CHECK ONLY ONE FORM OF PAYMENT:

Check -- Order Processed upon receipt of Payment ( $199.00 )

Credit card orders are processed within 24 hours.

American Express
Discover Card
Master Card
Visa

Name on Credit Card (Exactly as it appears):

Credit Card Number (please no spaces or dashes):

Expiration Month:

Expiration Year:


Total Charge Amount





Note: The information below refers to the individual completing this form and MUST be completed.
If information is the same as above you may Enter: Same. 
   Name 
   First & Last:  
   Phone No:      Required if same as above please enter "Same".
   Email Address: Required if same as above please enter "Same".



Press the "Submit" button to place your order

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