YourCitySurf.com
Find Everything You Need In Your City

Instructions: Print and complete form below. Mail along with check or, money order to the address below.

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Order Form Date______________

Business Name______________________________ Business Type_______________________

Business Address_______________________________________________________________

City____________________________________ State__________________ Zip____________

Business Phone#_________________________________ Fax#___________________________

Business Website URL (if business has a website)________________________________________

Contacts First Name____________________________ Last Name_________________________

Contacts Title___________________________________________________________________

Contacts Phone#___________________________________ Ext.__________________________

Contacts Email Address___________________________________________________________

Title of Business (as to be listed on directory)___________________________________________

Business Description (up to 35 words not including address and telephone number)_______________

______________________________________________________________________________

Type of Listing___________________________________________________________________

Price: $3.65

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Make check payable to: YourCitySurf.com

YourCitySurf.com Phone: (513) 232-3232 Fax: (513) 231-6657

Send Check, Or Money Order To:
YourCitySurf.com
2508 Beechmont Ave. #43
Cincinnati, Ohio 45230