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SUBSCRIPTION FORM

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Before we can begin creating your customized 4-page magazine, you must provide the following information. You may also print, fill out, and send in this subscription form.

* Required Field

1. Contact Information

Company Name *
	Mr. Mrs. Ms.
Contact First Name *
Contact Last Name *
Company Address *
City *
State *		Zip *
Telephone *
Fax
Cell
Email *

2. Company Owner/President *

3. Masthead Information:
Title of Magazine * (maximum 27 characters: e.g. Remodeling Tips, etc.)

Slogan or Description * (maximum 30 characters: e.g. A Family Owned Company, etc.)

Additional Information You Would Like On Magazine (Telephone, Fax, Email, Website, etc)

4. Return Address on Magazine *

	Same as Above Address
	Other Address:

5. Postage Area *
None - I wish to apply my own postage.
Catawba Mailing Service Indicia
Own Bulk Rate - type information below

	Permit #
	City
	State

6. Send Magazine To *

	Catawba Mailing Service
	Your company: (cannot send to P.O. Box)
	Your mailing service: (cannot send to P.O. Box)

7. Zip Codes * (This information is necessary for us to process your subscription. No zip codes will be reserved until the requested zip codes have been approved and the set-up fee is received.)

8. Copyright Permissions Statement * For publication in my issues of the magazine, I (the subscriber) will submit only photos and articles for which I have gained all necessary permissions. I understand that RT Marketing shall not be liable in regard to any disputes arising from the use of materials which I submit.
Name of responsible officer:

9. Choose Your Login Information *
Provide a User Name and Password for your primary company contact. Each should be easy to remember and 6-10 characters long. Do not use spaces or special characters. Once your account is active you will be able to add additional users for your company (up to 10 total).

User Name Password

10. Confirmation e-mails *
Would you prefer to receive your confirmation e-mails in HTML or plain text?