Advertisement Form "*" indicates required fields CommentsThis field is for validation purposes and should be left unchanged.Company/Organization or Individual*Contact Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Have you advertised in the Dust Bowl program before?* Yes No Do you want to run the same ad this year?* Yes, run the same ad No, I will send a new ad Ad Size* Full-Page Advertisement (8″ x 10″) – $225 Three-Quarter-Page Advertisement (6″ x 8″) – $200 Half-Page Advertisement (5″ x 8″) – $175 One-Quarter-Page Advertisement (4″ x 5″) – $150 One-Eighth-Page Advertisement (2″ x 4″) – $125 CommentsTotal Credit Card*Card Details Cardholder Name