ARVO/IOVS INSERTION ORDER
* Required fields
ADVERTISER: AGENCY:
*Company
*Contact
* Address  
* City/State/Zip  
* Phone  Ext.  
ex. 1112223333 		 Ext.
* Fax  Ext.  
ex. 1112223333 		 Ext.
* E-mail  
* Issue
  
* Month    
 
 
Look Up Table
* Size
* Color  
Materials:
File upload:  
NOTE: Maximum file size- 2MB and File format 'PDF'
New Ad to arrive at ARVO
Pick Up Ad From Issue Page Number
Special instruction:
Advertising Charges: Frequency:
Space Charge
$
 		 Color Charge

$  		 Gross Total
$
Agency Commission  $
Net Total Per Issue  $
Net Contract Total  $




I agree to the above ad placement and fees associated with advertising in IOVS or other ARVO Publication. All cancellations must be in writing. Cancellations will not be accepted after the space reservation deadline for the specific issues indicated on this form. Space reservation deadline is the 28th of the second preceding month for each issue. Cancellations not made in writing, or within the cancellation period will be charged to the advertiser at the full rate.
Authorized By Accepted for ARVO/IOVS BY
 
* Name
Name
 
* Title
Title
 
* Date
Date
 
 
 

© 2006 The Association for Research in Vision and Ophthalmology (ARVO)
12300 Twinbrook Parkway, Suite 250, Rockville, MD 20852-1606
Phone: 240-221-2952 - Fax 240-221-0355