EmailMe Form - Advertisement Form

Purchaser's Name *

First Last

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Date Ad Purchased *

MM / DD / YYYY

Select the ad size you are purchasing *

Note: add $5 to include a photograph

Message *

Write message exactly the way you want it to appear in the advertisement booklet.

Attach file

You may attach picture, business card or pre-constructed ad here.

Pay online using the donation button on the home page.

If sending by mail, make check or money order payable to:

Upscale Studio, Inc.
1842 Palisades Drive
Royal Palm Beach FL 3341

All monies and ads must be received by June 10, 2018. After this date, there is no guarantee that your ad will be published. For further questions please contact Regina Brown at 561.236.8625 or Ernest G. Brown at 561.316.9395.

Total Price *

$ Dollars . Cents

Total amount of Ad. Don't forget to add $5 for a photograph.

Seller's Name *

First MI Last

The name of student who is responsible for getting this advertisement