Advertising Application

* indicates required fields.

Company Name: *
Contact Name: *
Address: *
City: *
Province: *
Postal Code: *
Telephone: *	(Add as: 000-000-0000)
Fax:	(Add as: 000-000-0000)
Toll Free:	(Add as: 000-000-0000)
E-Mail: *
Web site:
60-word description:*
Geographical Area: *
Category: *
Rating:
Hours of Operation: *
Release of Information Authorization *

* Listing information will be included with advertisement
* All web links must provide a link back to www.centralnovascotia.com.
(CNTA will provide you with a logo)

Please complete and return to CNTA with Payment. You may also include two coloured photos and a logo.

Please send photos and cheque to CNTA's office at:
65 Treaty Trail, Millbrook, Nova Scotia, B6L 1W3

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