Platinum Ad

PLATINUM LEVEL AD SPONSOR

Type of Ad*

Business AdFamily/Happy Ad

AD LISTING DETAILS

The information in this Ad Listing Details section will be published in the Harvest Drive E-Directory in early November. If you are purchasing a Family/Happy Ad, please complete the Family Name and Description/Message fields ONLY.

Business or Family Name*

If placing a Business Ad, describe your company or services. If placing a Family/Happy Ad, list your message. The Description/Message is limited to 100 words or less.

Description/Message

0/100

Author

Date

Slug

Status

ID

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Facebook

Twitter

Google Plus

Website

E-mail

CATEGORY

What category best describes your advertisement? Select "Family/Happy Ad" for non-business ads that express well wishes to PCHS or a student. Can't find an existing category that suits your business? No problem, simply select *custom category at the end of the drop down list and enter your category.

Choose Category*

Custom Category*

STUDENT CREDIT

Is there a PCHS student(s) or family that should receive credit for selling this advertisement?

Student/Family Credit?*

Yes, student name(s) listed belowNo, apply credit to a PCHS family with financial need

NOTE: In cases of families with two or more students at PCHS, please list only one of the student's names. Credit will be divided equally among siblings.

Student 1

First Name Last Name

PCHS ID # (if known)

ADDITIONAL STUDENT CREDIT

You may add up to three additional students or families. Credit will be divided proportionally.

How many additional students?*

NO additional studentsOne (1) additional studentTwo (2) additional studentsThree (3) additional students

Student 2

First Name Last Name

PCHS ID # (if known)

Student 3

First Name Last Name

PCHS ID # (if known)

Student 4

First Name Last Name

PCHS ID # (if known)

PURCHASE OPTIONS

Purchaser's Name*

First Name Last Name

Purchaser E-mail*

Choose Purchase Option*

Paypal/Credit CardCheck mailed to PCHSCheck hand-delivered to PCHSCheck given to student to turn in

Confirm PayPal?*

Platinum Level Ad Listing$500.00

Sponsorship Level

$500

IMPORTANT - PLEASE READ THE FOLLOWING INSTRUCTIONS

Make check payable to PCHS
Write "Harvest Drive" in the memo section of the check
Include a printed confirmation of your online ad submission (you will receive via email)
Mail to:
Providence Catholic
Attn: Harvest Drive
1800 W Lincoln Hwy
New Lenox, IL 60451
Select "Yes" below once you have completed reading these instructions

Did you read instructions?*

Yes

NOTE: Upon selecting the Submit Ad button below, you will be redirected to the safe and secure PayPal website. You DO NOT need a PayPal account to make this payment; you may pay with any major credit card.

Enter text as it's shown*