MAILING LISTS CONNECTION#2 - FREE WebSite Offer

Please fill out the form below.
When you are done, be sure to click on the "Submit" button on the bottom of the form.
If your browser cannot handle forms or if you have problems with this form, e-mail us your order at order department or software department. Please note that in order to send you your order, your e-mail address must be valid.

Quick Action
Order Form

Dealership Option # Choice : Check one - #1 or #2
Listing Entry : (3 Lines Max each line seperated by ",") Name/Company, Address, City/State/Zip/Country
Website Name ( Primary Choice ) : Maximum 8 characters. No spaces, symbols, or punctuation marks
Website Name ( Back-Up Choice ) : In case your Primary Choice is already taken

Your Full Name:

Company Name:

E-mail Address (required):

Daytime Phone Number:

Address:

City:

State:

Zip:

Country:

Payment Method: Credit Card Check MoneyOrder

Important: If you wish to send information via post office, Make payments payable to:
TargetMan Agency
P.O. Box 399, Lubec, ME. 04652 USA
and print out and mail this form with proper payment.

Fill out the credit card info below:

Credit Card Type:

Name on card:

Card Number:

Card Exp. Date: s

Credit Card Authorization
(type 'I AGREE'):

Additional Comments:
Where Did You Hear About Us?:
Search Engines (Enter Name)
Direct Email
Our Website
Print Advertising
Other

_{EACH
WEBSITE IS INDEPENDENTLY OWNED}
_{COPYRIGHT 1998 TargetMan
Agency

THANK YOU FOR YOUR ORDER.}

Accessories, Adsheet Resource, Allergy, Antiques, Art Galleries, Arts and Crafts, Auto Dealers, Automotive, Aviation, Beauty, Beverages, Big Mail Express, Boating, Books, Books & Media, Bookstores, Business and Finance, Business Ideas, Business Opportunities, Careers, CDROMs, Circular Mailers Wealth, Classified Ads, Clothes & Fashion, Clothing, Coins, Collectibles, Collectors, Computers, Computers, Consumer Electronics, Fraud Alert Network, Cookies, Cosmetics, Crafts & Hobbies, Crafts & Hobby, Dating Services, Decorations, Depression Remedy, Directory Listings, Discount Advertising Resource, Display Ads, Domain Name, DOS & The Internet, Download Software, Education, Electronic Books, Electronics, Employment, Entertainers, Entertainment, Entrepreneur Weekly, Finance & Banking, Financial, Financial Freedom, Financial Opportunities, Flea Market Dealers, Florists, Food & Beverage, For Sale Misc, Fortune 500, Fun & Games, Furniture, General Merchandise, Gifts, Gym, Hand-Made Crafts, Health Care Products, Hints, Home & Garden, Home & Office, Home Based Business Ideas, Home Based Businesses, Home Design, Home Entertainment, Homeworkers, Household & Furniture, How To Start An Internet Home Business, Hunting and Fishing, Imports, Income Producing Businesses, Income Producing Ideas, Information Services, International Dealers Showcase, Investing, Java, Jeweler, Jewelry, Kitchen & Cooking, Knowledge, Legal Services, Lifeplus Membership, Links To Your Web Pages For Your Business, Lists, Magazine Rack, Mail Order Drop-Shippers, PC Magazines, Mail-List SourceBook, Making Money, Marketing & PR Personal Services, Medical, Microbusinesses, Miscellaneous, MLM-Network Connection, Money Making Ideas, Money Making Opportunities, Motorcycles, Multi-Level Marketing Recruiting, Music CDs, National Mail Order Service & Products Guide, Networking Opportunities For Your Home Business, Newsletters, Opportunities, OS/2, Pet Nutrition, Photography, Professional Services, Promotional Goods, Psychics & Fortune-tellers, Real Estate, Recipes, Recreational Vehicles, Reference, Relocation Services, Rich Happy, Self-Publishers Marketplace, Selling, Services, Shoe-String Business, Shoes, Shopping Mall, Small Business Ideas, Small Businesses, Small-Biz Freebies, Smoking, Specialties, Sporting Goods, Sports, Stamps, Start-Up Businesses, Success, Sweets & Snacks, Technical Books, The International E-Mail Pen-Pal List., Tips, Tobacco, Toys and Games, Trading Cards, Travel, Travel Agencies, Travel Books, Travel Ideas, Tricks, Vacationing, Videos, Vitamins, Web Site Services, Web-Biz Money Mall Complex, Weddings & Ceremonies, What's New Page, Wholesalers SourceBook, Be Your Own Boss, World Food, World-Trader Connections

Your Full Name:
Company Name:
E-mail Address (required):
Daytime Phone Number:
Address:
City:
State:
Zip:
Country:

Credit Card Type:
Name on card:
Card Number:
Card Exp. Date:	s
Credit Card Authorization (type 'I AGREE'):