| Print out and complete this form | |||||||||||
| Local Computerized Services | |||||||||||
| Featuring the new Internet Commercials called "Webmercials" (AAC listing included) | |||||||||||
| Visit AAC online (www.AllAmericanCommunities.com) | |||||||||||
| Subscription Form | |||||||||||
| www.LocalComputerizedServices.com | |||||||||||
| Mail to: Local Computerized Services, P.O. Box 6708, Falls Church, VA 22046 | |||||||||||
| Already have a web presence? | Video Web Presences (VWP) are $499 | Office Use | |||||||||
| Annual Subscription Listing $199 | All subscriptions are annual services | Application Number | |||||||||
| (link to All American Communities - AAC) | Listing | Webcard | Webmercial | VWP | |||||||
| Please include your check with application | $199 | $99 | $399 | $499 | |||||||
| Company Name & Address | Your Name | Your Current URL | |||||||||
| Name: | |||||||||||
| Address: | Your Title | Your Email Address | |||||||||
| Your Phone # | Requests | ||||||||||
| County: | |||||||||||
| Number of Employees: | Your Fax# | ||||||||||
| Annual Sales: | |||||||||||
| Please circle below the One category that best describes your product/service: | |||||||||||
| Family | Real Estate | Education | Careers | Workplace | Professional | Online | Commerce | Travel | Food | Entertainment | Health |
| Automobiles | Consulting | Financial | Appliances | Medical | Government | Pets | Construction | Apparel | Manufacturer | Gifts | Other |
| Your Contribution: Describe your Services/Products in detail (and attach a brochure) | |||||||||||
| Please circle below all categories that best describe the nature of your business: | |||||||||||
| Local | Regional | National | Worldwide | Retail | Wholesale | Factory | Engineering | Hi Tech | Services | Products | Diversified |
| Growing | New | Small | Medium | Large | Home Based | Subsidiary | Franchise | Corporate | Partnership | Sole Proprtr | Other |
| Tell us your business story (the Founder, special features, why should people patronize your business, how you got started, etc.) | |||||||||||
| Please circle below all categories that best describe your primary customers: | |||||||||||
| One Time | Repeat | Seasonal | Occasional | Online | Walk In | Individuals | Businesses | Corporations | Resellers | Consumers | Government |
| Men | Women | Ethnic | Educational | Home Owner | Wealthy | Young | Mature | Industrial | Healthcare | Professionals | Other |
| Is your entity a volunteer organization? | Are you interested in trading or bartering your services? | ||||||||||
| Are you a "not for profit"? | For a FREE 1 year subscription, would you refer 3 paying clients? | ||||||||||
| Do you have a marketing budget? | Does your entity have similar offices in multiple cities? | ||||||||||
| Today's Date | Your Signature | Office Use (agent name) | |||||||||
| By signing this application, I agree to the terms and conditions listed on www.AllAmericanCommunities.com | |||||||||||
| *add $35 for domain name; and, $49 for website forwarding w/o banner | |||||||||||