First Name     Middle Initial   Last Name

Title             

Publication   

Address      

City                   State       Zip Code

E-mail            Telephone   Fax

     I want the column sent until I cancel. I understand that it runs 1 time weekly, and that fresh copy will be available 7 (seven) days before the "Release By" date--AND THAT OUR RATE IS ONLY $5.00 PER COLUMN.  Forget the Rate Card.  

Our Circulation is      

We want to begin service on this date:

Mike, please supply Is That A Fact! columns in the following format --

       I want the column manuscript sent as plain text email to this email address:  

       I want this column as an email attachment in WORD.doc format to this email address 

       I want the column weekly as an email attachment in .pdf format sent to 

       I want the column weekly via FAX to (area code + nnn-nnnn)