COUPON CITY'S ADVERTISING FORM
 Please right click on page and hit print then fill the form below and mail it to us !
 
ADVERTISE YOUR COMPANY ON THE INTERNET WITH OUT HAVING A WEB SITE
 
PUT YOU COUPON ON THE NET FOR LESS THEN A NICKEL A DAY
ONLY $15.00 A YEAR
PLEASE FILL OUT AND MAIL  THIS PART TO US
Company name                                                
Your name                                                       
Your title                                                         
Authorizing signiture                                         
Phone number       (     )-           -                     
Address                                                           
                                                                        
OUR ADDRESS

 M.S.M.  

 P.O. BOX  2509 

 DUNEDIN  FL. 34697 

Please make checks payable to M.S.M.  
 
Phone number    (727)-734-8346
YOUR COUPON INFO
 1.    Amount of discount  you would like to offer________       %   or   $  
 2.    Local  or  national 
 3.    Expiration date __________optional 
 4.    Would you like a validation code on your coupon   yes   or    no 
please no more then six numbers                                  
 5.    Would you like to use your company logo on coupon 
   yes   or   no
( if yes please send your logo with this form) 
 6.    Please fill in what item or items you wish to discount (Ex: kids eat free with purchase of 
       an adult meal) 
                                                                                                                                                
                                                                                                                                                
 
 
FINAL CHECK LIST 
1. did you fill out the form complete 
2. did you enclose your logo 
3. did you enclose your check 		FOR OFFICE USE ONLY PLEASE DO NOT WRITE IN THIS BOX 

Sales Authorization code number (00     -     ) 
 
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