After-School Activities Listing Form

Business Name:
Contact Name:
Billing Address:
City, State, Zip:
Phone:
Email Address:
Please select months to be published:
- One Full Calendar Year (12X)
- January
- February
- March
- April
- May
- June
- July
- August
- September
- October
- November
- December
Select the number of times you would like your advertisement to run. Please note that frequency discounts are available. 1-5 months: $70 per month. 6-11 months: $65 per month. 12 months: $60 per month.
Payment Information:
Please tell us which option you will be using for payment. Your card will be charged on or around the 15th of the month prior to publication.
Credit Cart Number (if applicable):
Expiration:
Security Code:
Check Number (if applicable):
Receipt Required:
If you need a receipt, please list the email address of the individual who should receive the receipt.
Listing Info
Activity/Program Name:
Address (if different from above):
City, State, Zip (if different from above):
Contact Name - Admissions:
Phone Number - Admissions
Email Address - Admissions:
Website Address:
Ages/Grades
50 Word Description:
This is a description of your school/programs.
Sales Representative:
If you know the name of your sales rep, please choose their name.

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Indy's Child Magazine | 921 E. 86th Street, Suite 105, Indianapolis, IN 46240

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Listing Info