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Nurses for a Healthier Tomorrow TV PSA Media Kit Order Form

 Call TV Access with questions 800-944-9134
 
PRODUCT SELECTION
TV PSA Media Kit
Betacam* :

Qty: @$100/each.

YES! I want to localize these tags. (BETACAM ONLY)

I want Localized tags at $150/each. Please fill in requested info on bottom of page.

VHS:

Qty: @$25/each

You will be invoiced by TV Access for the total of your order.

Click here if you would rather fax your order and pay by credit card.

* Betacam is for Broadcast TV Stations Only




SHIPPING INFORMATION
Delivery Requested by: Normal delivery is 7 working days
Special delivery upon request
Name:
Organization:
Phone: ( )- -
Fax: ( )- -
Email:
   
Delivery Address (No PO Boxes)
Delivery Address (continued, if necessary)
City:
State:
Zip Code:
   
BETACAM ONLY - Stations Targeted:

(please check nursesource.org for current station receiving list)

BETACAM ONLY - Information you want to appear on your tag:

(The information will appear on the last frame of the ad and will read: "This ad compliments of [organization name].")