A-2-R AMERICA-TO-RUSSIA: Business to Business Directory

Order Form

Print out this order form and mail it along with your advertisement and check to:

Name/title: _____________________________________________________

Company:______________________________________________________

Street Address:__________________________________________________

__________________________________________________

Phone: ( ) __________________________________

Fax: ( )____________________________________

Ad size: ( ) 1/4 page, ( ) 1/2 page, ( ) full page

I have read and I agree with the Issuance and Closing Terms

______________________________________________________

Applicant (signature and title of customer or authorized representative)