Modern Silver Magazine Secure Order Form

ADVERTISING RATES
AND SECURE ORDERING FORM

GALLERY SHOPPING ...........$250.00 per year

(To advertise on the gallery shopping page, please fill out the form below.)

Name

URL of website

E-mail Address

Physical Address

Phone

Comments

Fill out secure credit card form at the bottom of the page; or e-mail us to arrange payment by check or money order; or you may use Pay Pal. Please indicate payment for: editor@modernsilver.com
____________________________________________________________

LINKS AND MARKETPLACE...........$75.00 per year for a jeweler's link or a marketplace link.

(For a link on our links page or a listing in our marketplace section (including the jeweler's page or metalsmiths, repair and jewelry supplies page), please fill out the form below. In the comments section, please indicate for which page you are requesting a link.

Name

URL of website

E-mail Address

Physical Address

Phone

Comments

Fill out secure credit card form below; or e-mail us to arrange payment by check or money order; or you may also use Pay Pal. Please indicate payment for: editor@modernsilver.com
___________________________________________________________

BANNER ADS..........$240 per year

(To advertise with a banner ad, please fill out the form below.)

Name

URL of website

E-mail Address

Physical Address

Phone

Comments (If you already have an ad designed, please include a url to the ad. Also please e-mail us so we can discuss placement, size, etc.)

NEW: LIST ITEMS FOR SALE!

If you wish to list items for sale, please submit $5.00 for each item and email photographs and descriptions to info@modernsilver.com The listing fees are good for one month and can be renewed for extra months if desired.

Fill out secure credit card form below; or e-mail us to arrange payment by check or money order; or you may also use Pay Pal. Please indicate Pay PaL payment for: editor@modernsilver.com .
____________________________________________________________

Payment Information
This order form is secure. It is encrypted during transmission using Secure Socket Layer (SSL) technology so you can safely use your credit card.

Select Payment Method Cardholder's Name

Credit Card Number Expiration

Dealer Ad Cost:

Link Cost:

Banner Ad Cost:

Total Payment Amount:

For check or money order payments, mail to:
Modern Silver Magazine
PO Box 656
Natchez, Mississippi 39121
For Pay Pal use editor@modernsilver.com

Before you submit,
please be sure the form information is correct and complete.
Note: Please be patient. This form may take a minute or two to submit. A "Thank You" page will appear when it has been successfully submitted.