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Enhanced Listings Form

'Top Listing' on the page, 'VIP+'  Listing or 'VIP'
Listing on GreatLakesonLine.com Directory

Please provide the following information:

Business/Organization
Street address
Address (cont.)
City
County
State if other, specify in comments below
Zip/Postal code
Phone
FAX
E-mail
URL(web site)

Do you want your E-mail address listed?    YES   ,  NO

Do you want your URL listed?    YES ,  NO

Please provide your contact information, for questions:

First name  
Last name  
Phone
Email

Do you want this contacts name listed?    YES   ,  NO

Suggest one general category which best fits your business/organization.

 Where did you find us?

Please suggest the specific keywords which best describes your business/organization.

What organizations are you associated with?

Select one or more
(if they apply)
(Ctrl + Right Mouse click
for multiple selections)
 
Up to 100 word description of your business/organization/company
 
If your billing information is different from information listed above,
Please enter that information below:

Same as above (check if applies)

First name
Last name
Middle initial
Title
Phone
Organization
Street address
Address (cont.)
City
County
State if other please give in comments.
Zip/Postal code
E-mail
 
1 Year Commitment required I agree
 
Listing Options:

 **Top Listing on the Page* * $18.00 per month, click on link below for payment

**VIP+ Listing** $8.00 per month, click on link below for payment
 
 
*VIP Listing* $4.00 per month, click on link below for payment  

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GreatLakesonLine.com & LR Associates, Inc.

 

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Please complete form as completely as possible,
then click the Submit Information button ONLY once.

You will be contact you within 3 weeks for your
credit card information.  Thank you. 

**If you have any questions regarding a listing**
 Please call: Laurie 248.486.6033
 
 

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