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ECS Advertising Insertion Order and Contract (1 of 2 pages) Thank you for your support!

Advertiser Category

Insertion Order Type:

Media Placement: (check all that apply)

¨ New Advertiser ¨ Existing Advertiser ¨ Sponsor/Exhibitor

¨ New ¨ Renewal

¨ Interface Magazine ¨ ECS Digital Library ¨ ECS Website ¨ Redcat Blog

Advertising Agency:

Advertiser:

Media Contact:

Division:

Address:

Media Contact:

City/State:

Address:

Zip:

City/State:

Phone:

Zip:

Fax:

Phone:

Email:

Fax:

¨ ECS e-news ¨ ECS Meetings ¨ ECS Combo Package ¨ ECS “Build Your Own Package”

Email: Ad Type (check all that apply) Ad title: Bleed:

Issue/Frequency:

Subtotal

Total Cost

$

$

¨ Interface

Size:

¨ ECS Digital Library

Banner Type:

Frequency:

Start Date:

$

$

¨ ECS Website

Banner Type:

Frequency:

Start Date:

$

$

¨ Redcat Blog

Banner Type:

Frequency:

Start Date:

$

$

¨ ECS e-Zone

Banner Type:

Frequency:

Start Date:

$

$

¨ ECS Meetings

Please contact Casey Emilius; sponsorship@electrochem.org

$

$

¨ ECS Combo Package

Please contact Casey Emilius; sponsorship@electrochem.org

$

$

¨ ECS “Build Your Own Package”

Please contact Casey Emilius; sponsorship@electrochem.org

$

$

Total Amount Due Credit Card Information

Invoicing Information

Name on Card:

Attention:

Billing Address:

Company:

City:

Address:

State/Province & Zip:

City/State:

Country:

Zip:

Card Holder Phone #:

Phone:

Choose Type: ¨ Mastercard

¨ Visa

¨ Amex

¨ Discover

$ $ 0.00

County:

Fax:

Card No.

Email:

Signature:

Expiration Date: Check enclosed $ 0.00

Signature:

(payable to ECS) Date:

Please also review, approve, and sign page 11; REQUIRED.

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2016 ECS Media Kit