Purchaser Signature: X__________________________________________Date:_________
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Extra Postcards: 1st 1,000 = $150, each additional 1,000 = $125 |
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| Market Areas & Approx. quantity: Enter for Greenwich: 11,814, Westport: 7,045, Stamford:8,236, Fairfield: 6,948, New Canaan: 4,864, Darien: 4,905, Wilton: 4,359, Norwalk: 5,643, Ridgefield: 4,530, Weston: 2,879, (For all towns enter 61,223) |
Company Name (please print):________________________Phone:(___)_____________ Address:_______________________________City:____________State:____Zip:______ Authorized Purchaser Name (please print):_________________________ Purchaser Signature: X__________________________________________Date:_________ AMDPS Authorized Signature:_____________________________________Date:_________