Bayescort.com Advertising Order Form

Please choose the advertising package you would like:

1. “Economy” -- $55/month
2. “VIP” -- $85/month

How would you like to pay? (circle one)

1. Credit Card
2. Debit Card
3. Check
4. Money Order

If Credit Card or Debit Card

You can either call us with a credit card, or fill out the information and fax it to us at 1-901-284-2449, OR mail it to:
Bay Online Media, LLC
PO Box 225249
San Francisco, CA 94122-5249

Name on card: ____________________

Type of card: ____________________

Card number: ____________________

Expiration Date: __________

If Check or Money Order

Refund Policy

Refunds will be issued only for:

1. Ads that are non-published ads
2. Ads that do not run for an entire month due to technical or other problems relating to Bayescort.com

I agree to the above terms and would like to begin my advertising campaign:

Your signature: _____________________________________

Date: __________________