"From the Heart" Ad Order Form

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Please note that we reserve the right to refuse the materials or photos based on our discretion.

First Name *

Last Name *

Phone Number *

Address 1 *

Address 2

City *

State *

Zip Code *

In which newspaper will your ad be running? *

Dayton Daily News

Journal-News

Springfield News-Sun

Required

Choose occasion for your ad. Please pay attention to the ad submission deadlines *

Choose you ads size and template *

1x2

2x3

3x5

I would like to request a Special Wording and Ad Size

Required

Text for the ad. You can include up to one paragraph *

Photo - email your photo to FromtheHeart@coxinc.com. Make sure to include your name and phone number when sending *

I have emailed the picture to FromtheHeart@coxinc.com

I will email my picture after my payment is processed

I confirm that the picture I have submitted can be published in the newspaper (both paper and e-paper editions). If I am ordering an ad for someone else - I confirm that I have that person's/that person's family or legal representative(s) permission to publish the photo in the newspaper (both paper and e-paper editions) *

Yes

Method of Payment *

CHECK: please choose this option if you would like to mail your check made out to Cox Media Group Ohio to Attn. Classified Dept., 1611 S Main St, Dayton OH, 45409. Any checks need to be mailed 7-10 days prior to the ad run date.

CREDIT CARD: please choose this option if you would like to call us at (937)223-1515 for securely processing your payment over the phone.

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