PBL News & Website - Advertisement Request Form
Please enter the information for your AD that you want to submit to the Palm Beach Leisureville News. Please be sure to complete the entire form. All ADS are for a minimum of 3 months and will run until we are notified with a min. of 30 days notice prior to the publication date which is always the 1st of the month. IE: if you want to cancel your ad for Feb then we must be notified prior to January 1st. There is a $25.00 per ad set up fee if we have to design/re-type your ad. Payment is due immediately upon submission - Please make checks payable to and mail to: PBL NEWS - 1007 Ocean Drive, Boynton Beach, Fl. 33426

First Name:*
Last Name:*
Email Address:*
Contact Phone:*
Company (if any):
Address:
City:*
Zip:*
Newspaper - Size of Ad (Bus Card,16th,8th,1/4, 1/2, full):*
Color Y or N (extra charge $80 full page; $40 half page; $25 quarter page; $15 eighth page):*
Website Ad - Type (Business Card - no link to website or video, Banner Ad (Business Card size) - includes link to website or video):
Enter your ad's Lisiting Category (Plumbing, legal, Medical, etc.):*
Start Month:*
End Month (minimum of 3 months from start date):*
Attach Ad (jpg, pdf, doc, or gif file):
Additional Attachments (jpg, pdf, doc, or gif file):
Additional Attachments (jpg, pdf, doc, or gif file):
Additional Attachments (jpg, pdf, doc, or gif file):
Additional Attachments (jpg, pdf, doc, or gif file):
We Design your Ad - Enter Text for your Ad here and a fee of $25.00 will be charged:
To prevent automated SPAM, please enter CGL3 to submit your form (case sensitive):*
 

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This site is provided by Palm Beach Leisureville