Alcance Media Group

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Publisher application form.

* Red fields are required.

Complete and submit the form below to apply to participate in the AlcanceMG Advertising Network.

First Name:
Last Name:
Title:
Company Name:
Address:
City:
State/Province:
Zip Code:
Country:
Phone Number:
Fax Number:
Email Address:

Website Info

Site Name:
Site URL:
Category 1:
Category 2:

Banner sizes your site accepts:

728*90 350*250
160*600 Interstitials
Pop-Under Floating banner

Please enter a description of your site:

Billing Information

Payee Name :
Make payment via:
PayPal Enter e-mail
Check Enter Address

  Publisher Agreement:

In order to join the AlcanceMG Ad Network, you must enter into a Web Publishers Contract with AlcanceMG. The contract:
Prohibits any content deemed inappropriate by Alcance Media Group at its sole discretion.
Requires that web sites place AlcanceMG ads above the fold on their web pages.
Prohibits the use of robots or any other fraudulent way of generating ad impressions or click-throughs.

  I have read and accept the terms and condition of the Web Publisher Contract. Agreement*

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