Home Page Banner Ad Submission Form (3 Months)

Banner Ad, Home Page Only | 3 Months - $765

Three-Month Placement
Rotating Home Page Banner – 728 x 90 pixels

* Company

* Address

* City

* State

* Zipcode

Country

* Primary Contact First Name, Last Name

* Primary Contact Title

* Primary Contact Email

* Primary Contact Phone

* Upload Image File Please upload your advertisement per the following size requirements: Banner Ad (728 x 90 pixels)

* Web Link URL http://www.yourwebsite.com

Payment Options

Please note that you will not be directed to a payment page once you submit this form. Please refer to the options below and make your selection. If paying by credit card, please copy and paste the provided link, which will direct you to the payment page for this sponsorship.

* Payment Options Please select how you will submit payment.

Will pay by credit card immediately following this application (please copy and paste this link in a new browser tab to make your payment: https://aiapv.starchapter.com/catalog.php?cat=5&pid=42)
Will send check (payable to AIA Potomac Valley)
Send an invoice please

Questions and Comments List any questions or comments you may have regarding this application.

Members Log In
Please use either your email address (the same one you use for AIA National) or your AIA number to log in. Please note that AIAPV members whose membership is lapsed as of March 31st will no longer receive member event prices or other discounts. Non-renewed members will receive an "Invalid username or password" message when attempting to log in as a member and will need to complete a guest registration. If you haven't yet created your member login and password (necessary prior to registering for events) please click the "Forgot Username/Password?" link below and follow the instructions to create login access:

Password:

	Forgot Username/Password?

Home Page Banner Ad Submission Form (3 Months)

Payment Options

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