Dining Listing Form


Complete the following information and when complete press the "Submit Form" button at the bottom of the page (ONLY PRESS ONCE)

Your listing will be added within 3 - 5 Business Days, and you will be billed for the $25.00 fee.                   THERE IS A FEE FOR THIS AD.  1 YEAR FOR $25.00.

Please provide the following contact information:

First Name
Last Name
Title
Restaurant Name 
Type of restaurant
Ad Package
 Dinner Entree Price
PROMOTION CODE:
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL

Please provide the following information on the company to be listed (IF DIFFERENT THAN ABOVE)

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL
Narrative Description of Business:

  Use PayPal link to pay for your ad with your credit card or bank account.  It's a FREE service.  If you have not already used PayPal to make your payment go ahead and submit this form 1st.  Then use the "Back" button on your browser to use the link on the prior page.    

CLICK HERE TO BECOME A MEMBER COMPANY IN OUR DISCOUNT CLUB - IT'S FREE

PLEASE ONLY PRESS "SUBMIT FORM " BUTTON ONCE!!

I will email you when the ad is up.  Then if you have any changes once you see it, that's not a problem.



Copyright 2000  SNOWBIRDHELPER.COM.  All rights reserved.
Revised: February 19, 2007