Digital Advertising Request Form

First Name:  
Last Name:
 
Dept.:  
Phone:  
E-mail:  

Ad Name:   

Vendor's Due Date:   [None] Select a Date Delete the Date   

Beginning Run Date:   [None] Select a Date Delete the Date   

Ending Date:  [None] Select a Date Delete the Date  

Publication Name:   

Content/Message:

 

Submission Specs. Copy and paste specs from publisher or supply URL for specs:

  

Size:  Height  pixels  X  Width  pixels

Approvals: 

 

Does this ad link to a website? If so, supply page URL:

 

Additional Comments/Instructions: