TheBlackMarket.com (TM)

SERVICE ORDER FORM

1) PRINT THIS FORM.

2) Put an "X" in the box for the plan you want, and complete the form.

Your Name:_____________________________________________ Date

Company Name:____________________________________________

Street Address:_________________________________________ City:______________________

State:_________ Zip:____________ Phone:_______________ Fax (Optional):_________________

Email Address (Optional):

Internet Home Page Address (Optional) :_______________________ ____

Your Title:__________________________

Your Signature:___________________________________________________

Text to accompany your listing:

Brief profile of your company for inclusion in TheBlackMailer® Newsletter:

3) Mail this form, a color or B&W photo to accompany your ad (no photos in classified ads) and a U.S. check or money order made out to GriffinDesigns to:

GriffinDesigns
P.O. Box 231
Hiram, GA 30141

***********There is a $10 charge for returned checks!***********

Can't print the form? Email us your name and mailing address, put "Service Order Form" in the Subject Line and we'll send you the form!

Or use Paypal! Just go to the Prices Page and pick your plan!