Directory Listing Submission

For A Magazine of People and Possibilities
Online Website - Immediate Placement
and Upcoming Spring 2012 PRINT ISSUE
ALL For One Full Year

Please fill in only the specific information that you
actually want included in your directory listing.

For example, if you do not want your address included,
then simply leave that space blank.

Full Name:

Company Name:

Address:

Telephone:

Fax:

Email:

Website:

Description of the work that you
do, your product and/or service.
(UP TO 30 WORDS.)

Do you have any comments,
questions or special instructions
about your listing.
(Optional)