Advertising Request Form 
 
First Name*
 
 
Middle Name
 
 
Last Name*
 
 
Email Address*
 
 
Company Name*
 
 
Street Address
 
 
City
 
 
State
 
 
Zip Code
 
 
 
 
Mobile Phone
 
 
Office Phone
 
 
Home Phone
 
 
 
 
 
Affiliate Options 
 
 
 
1 Ad - $120
 
 
8 Ads - $640
 
 
 
2 Ads - $220
 
 
16 Ads - $1,200
 
 
 
4 Ads - $340
 
 
24 Ads - $1,700
 
 
 
 
 
 
Non-Affiliate Options 
 
 
 
1 Ad - $150
 
 
8 Ads - $800
 
 
 
2 Ads - $275
 
 
16 Ads - $1,500
 
 
 
4 Ads - $425
 
 
24 Ads - $2,100
 
 
 
 
 
 
Ad Run Requested Start Date
 
 
Ad Run Requested End Date
 
 
 
 
 
 
I am an affiliate member
 
 
I agree to submit payment per our agreement to run ads with the Minneapolis Area REALTORS®.*
 
 
 
 
 
Upload your 800 x 800 ad: