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June 2008 Issue

IT Defense 2008 Media Kit

IT Defense Media Kit 2008
    View the Media Kit (pdf file)

Advertiser Credit Application
Please fill out the form completely and accurately:
 Account Name:  
 d.b.a./trade style:  
 Amount of Credit Requested:  
 Street Address:  
 Address:  
 City:  
 State/Province:  
 Zip/Postal Code:  
 Federal Tax ID:  
 Work Phone:  
 Fax:  
 Email:   
 Advertising Consultant:   
 Account #:   
 To which location are you applying?    
 Is your business a:    
 Date started in business or assumed control:   
 Nature of business:   
 Number of employees:   
 Name & address of previous employer   
Officers or Principals:
 Name:   
 Title:   
 Residence:   
 SSN:   
Officers or Principals:
 Name:   
 Title:   
 Residence:   
 SSN:   
 Is company registered?   
 In what state?   
 Date of filing?   
 Have you previously done business with us?   
 Under what name?   
 Account Number?   
 Dates?   
Credit References:
 Organization:   
 Street Address:   
 Address:   
 City:   
 State/Province:   
 Zip/Postal Code:   
 Account #:   
 Phone:   
Credit Reference:
 Organization:   
 Street Address:   
 Address:   
 City:   
 State/Province:   
 Zip/Postal Code:   
 Account #:   
 Phone:   
Bank Reference:
 Organization:   
 Street Address:   
 Address:   
 City:   
 State/Province:   
 Zip/Postal Code:   
 Account #:   
 Phone:   
Bank Reference:
 Organization:   
 Street Address:   
 Address:   
 City:   
 State/Province:   
 Zip/Postal Code:   
 Account #:   
 Phone:   
Confirmation and Authorization:
I/we certify that the information contained in this application is true and correct. I/we hereby authorize the release of credit information relevant to the above account.

If credit is granted, I/we personally promise to meet the following terms:

  1. Payment is due upon receipt of the monthly statement.
  2. Finance charge accrue monthly on all accounts greater than 30 days past due at an annualized rate of 18%.
  3. client is responsible for paying all finance charges in addition to the originally billed amount.
  4. Credit will not be reinstated on 60 day delinquent accounts until all non-current balances are paid in full.

I have read and understand the above terms
and am willing to abide by them.

 

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