Avid Angler Banner Sign Up Form

I. General Information: The following information is needed for each account.
Name: required
E-Mail: required
Phone Number:
Address line 1: required
Address line 2:
City: required
State/Province: required
Zip/Postal Code: required
Country: required
Site URL: required
Banner URL:
Password: required
II. Advert Information: The following information is used to define the "appearance" of an advert banner when called.
Account Name: required
Border:
ALT Text: required
Link Text:
Above Banner Below Banner
Are you supplying a banner:Yes No
If no to above, do want Avid Angler to create a banner for you.
Yes, create a banner for me. ($25.00 USD)Yes No
III. Banner Account Type: The following information is used to determine your account type.
6 Month Account ($50.00 USD)       
12 Month Account ($75.00 USD)     


*** NOTE

ONLY THE 6 & 12 MONTH ACCOUNTS QUALIFY FOR BANNER PLACEMENTS FOR THE TOP 1000 FISHING SITES.

IIIa. Banner Exposure Account Type: The following information is used to determine your exposure account type.
1000 Exposures Account ($5.00 USD)        
2000 Exposures Account ($7.00 USD)        
5000 Exposures Account ($15.00 USD)      
10000 Exposures Account ($25.00 USD)     
IV. Payment Method Information: The following information is used to determine payment options.
Money Order:
Personal Check:
Pay Pal:


By clicking here you agree to pay Avid Angler for the option choice amounts you have selected above
and that you have read the terms and conditions of the Avid Angler Banner Program and the FAQ's page..
Yes, I agree to pay for the above
selected choices and agree
to the terms and conditions.		 required
Press only once!

Please do not use this form as a way of modifying your account, email to change or modify your banner

Thank you for your patronage! If you require more information please contact .

Maintained with Avid Angler Banner Ads 1.00 .