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Banner Submission Form

Natural Health Web provides an opportunity to purchase very targeted banner advertising. Our website attracts very targeted visitors, interested in Natural Health and Alternative Medicine.
The following form is designed to enable you to submit a banner to be displayed at the top of the pages of the Natural Health Web Website. The banners are displayed just below the title of the page to provide maximum visibility. The only exception to this is on the Home Page in which the banner is placed in the middle of the page. Your banner will contain a hyperlink back to your website, providing a great way to quickly increase the traffic to your site.

In addition to submitting the form, please e-mail a copy of the banner as an attachment to webmaster@selfgrowth.com. The banner may be up to 468 L X 60 W pixels and up to 9 kbytes in size. The banner must be in "gif" format. If you do not have a banner, you can contact your local webmaster or you can create one online at no charge by visiting one of these two sites:

  1. Banner Creator
  2. PaceWorks Animation.Com

To place your banner on our website, please fill out and submit the form below:

Ad Copy Headline        (10 words):
Your Site URL:

Ad Copy Description

(30 words)

For Reference Purposes Only:

We accept Mastercard, Visa and American Express. If you wish to use our service, please order now as we can only accept a limited number of orders per week to maintain quality control. If paying by check, please print out a completed form and mail it with your check to Self Improvement Online, 96 Linwood Plaza, Suite 264, Fort Lee, NJ 07024. If you have any questions about our service, please write to us or call us at 1-732-761-9930.

Please provide the following information:

Contact Name:
Company: 
Address:
City, State, Zip:
Contact Email:
Phone Number:
Credit Card Type:  Mastercard VisaAMEX 
Name on Card: 
Card Number:
Expiration Date:  

I authorize you to charge the following amount to my credit card 

(All Charges in US Dollars):

Please add any additional notes/comments/suggestions:

 

 

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