Special Needs Form - Indy's Child Magazine

Special Needs Form

  • Select the number of times you would like your advertisement to run. Please note that frequency discounts are available. 1-5 months: $60 per month. 6-11 months: $55 per month. 12 months: $50 per month.
  • 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.
  • If you need a receipt, please list the email address of the individual who should receive the receipt.
  • Listing Info

    The info below will be used to create your listing. Please make sure all information is correct. Any fields left blank will not appear in your listing.
  • If you have more than one location please list the location address you would like to use for the listing.
  • This is a description of your school/programs.
  • If you know the name of your sales rep, please choose their name.
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