Annual Publication (Tabloid) Placement Payment 1Contact and Billing Information2Tabloid Placement Options Purchaser is an* Organization or Business Individual Name of Organization or Business*Name of Individual / Individuals*Name on Credit card* First Last Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Full Page Color (Vertical Orientation) Quantity Price: Full page placement cannot be used for two half page placements.Quantity Full Page Color1/2 Page Color (Horizontal Orientation) Quantity Price: Half page placement cannot be used for two quarter page placements.Quantity 1/2 Page Color1/4 Page Color (Vertical Orientation) Price: Quantity 1/4 Page ColorBusiness Card (3.5 x 2 inches) Price: Quantity Business CardPhoto Options We wish to use DBL participating photographer** We will furnish digital photo (300 dpi JPG) by January 8, 2025 We wish to donate space for DBL use. **Participating photographers are not paid for the photos they provide for the Tabloid. They generously donate their time and talent in support of DBL’s Grant Program.Photographer's name Discounted Ball Tickets at Members' Price Rate (0-4) Price: Discounted Ball Tickets at Members' Price Rate (0-2) Price: Purchase up to 4 Discounted Charity Ball TicketsPlease enter a number from 0 to 4.Since you opted for a full-page placement in the Tabloid, you are eligible for up to 4 Charity Ball tickets at the discounted members’ rate.Purchase up to 2 Discounted Charity Ball TicketsPlease enter a number from 0 to 2.Since you opted for a 1/4 or 1/2-page placement in the Tabloid, you are eligible for up to 2 Charity Ball tickets at the discounted members’ rate.Charity Ball Tickets Quantity Price: $160.00 Quantity Charity Ball Tickets without discount or restrictions.Your Total Purchase Amount $0.00 Δ