Z1 – Cee Media Advertising

Business Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Manager or Owner *

First

Last

Cell Phone (Office Use Only)

Email *

Approximate Delivery Date

Billed on the 5th of each month due by the 15th.
Email all logos, ad content, etc to email below. All proofs will be emailed and await a confirmation of approval or of changes to make by email.
Changes may be made monthly. Simply email the changes and the date the new ad will begin. Allow a minimum of 48 to 72 hours for changes to take place. Excluding weekends and holidays.
Advertiser acknowledges upon signing of this contract that he has not relied on statements or representations other than as contained herein and acknowledges receipt of a copy of this contract.

Special Instruction

Cee U Media Rep

Date / Time

Date

Time

Position

Signature - Name / Last 4 Numbers of SSN (copy)