Advertisement Contract Preparation Form

Supermarket Advertisement Contract Preparation Form

We require this information to prepare your agreement accurately. Please provide the necessary details to proceed.

Privacy Assurance
We value your privacy. Your information will only be used for the purpose of providing the requested service and will never be sold, shared, or used for any other purposes.

SuperMarket(Required)

Select Your Preferred Supermarket

Choose Your Advertising Service: Cashier Displays or Digital Roll-Ups

Your Name(Required)

First Last

Business Name(Required)

Your title(Required)

(for example: Manager, Owner, Representative,...)

Your Address(Required)

Street Address Address Line 2 City State ZIP Code

Your Phone(Required)

Your Email Address(Required)

Email Address Confirm Email Address

Type of Ad

Duration(Required)

(3 Month Minimum) North Park

Duration(Required)

(3 Month Minimum) Wholesome Choice

Duration(Required)

Select the desired duration for your event advertising at Wholesome Choice.

Duration(Required)

Select the desired duration for your event advertising at North Park Poway.

Start Date(Required)

we should have the Ad file(s) ready at least 4 days before this date.

End Date

Would you like to be featured in our printed brochure as well?(Required)

Yes

Selecting this option adds a $90 fee every 3 months, which covers both printing and design.

Printed Brochure Term(Required)

Please Select Printed Brochure Term (3, 6 or 12 Months)

Printed Brochure Term(Required)

Please Select Printed Brochure Term for Wholesome Choice Irvine (3, 6 or 12 Months)

Prices Listed Are for Information Only

No Payment Required via This Form

Display Ads Standard Monthly Rate(Required)

Price:

Not included any multi-month discounts

Display Ads Standard Monthly Rate (Wholesome Choice)

Price:

Not included any multi-month discounts

One-Time Additional Bundle Rate for Cashier Display & Digital Roll-Ups Ads

Price:

this additional $1200 will be applied as a discounted bundle rate (for 15 displays) instead of paying the full price for each service separately regardless of duration.

One-Time Additional Bundle Rate for Cashier Display & Digital Roll-Ups Ads

Price:

this additional $700 will be applied as a discounted bundle rate (for 15 displays) instead of paying the full price for each service separately regardless of duration.

One-Time Additional Bundle Rate for Cashier Display & Digital Roll-Ups Ads

Price:

this additional $880 will be applied as a discounted bundle rate (for 15 displays) instead of paying the full price for each service separately regardless of duration.

Event Ad Monthly Rate(Required)

Price:

Event Ad Monthly Rate(Required)

Price:

Event Ad Monthly Rate (Cashier Display + Digital Rollups)(Required)

Price:

an additional $600 will be added to the total amount for bundle of Cashier Display & Digital Roll-Ups Ads

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Discount 6 month NPP

$0.00

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Discount 1 year Wholesome Irvine

$0.00

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Discount 6 Month Wholesome Irvine

$0.00

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Discount 12 month NPP

$0.00

Total

No payment is required now—this amount is for informational purposes only. 3+ Month standard Discounts Included (If Applicable)

more info or any comments:

Upload your file(s)

Drop files here or

Max. file size: 2 GB.

Upload your ad image or a video in .mp4 format (maximum 25 seconds). If your file isn't ready yet, you can submit it later.