PREMIUM CRG ~ Community Resource Guide

Upon completion of this form we will email you your PREMIUM CRG PROOF for your review and approval within one business day.

*Asterisk denotes required field.

*Choose one, PREMIUM Community Resource Guide (CRG) base rates:

*Suggested CATEGORY
Examples: Chiropractic Physician, Craniosacral Therapy

*(1) ITEM - Business or Professional Name

Three additional ITEMS are included with your basic listing. Items over four are $5/mo. each for Broward County and $4/mo for Palm Beach County.

(2) ITEM - Contact Name
When including professional degrees earned, kindly limit to the top two.

(3) ITEM - Additional Contact Name

(4) ITEM - Address
Enter a comma after the street address, then add the City, State, and zipcode.

(5) ITEM - Telephone
Kindly use dashes. Example: 954-630-1610.

(6) ITEM - Fax

(7) ITEM - Email
Reminder: each ITEM you include over 4 is an additional cost.

(8) ITEM - Website (URL)

Use this section to share benefits, products and services. The basic listing includes up to 30 words.

As there is a monthly charge of $1 per word over 30, would you like assistance in reducing your description to 30 words?
Yes please.No thanks.
We recommend you make a backup copy of your description prior to "submitting," in the event this form does not process correctly.

Image (optional)
Types of images acceptable: png, jpg, gif, and pdf. 2 MB file size limit. Remove any slashes and spaces within your graphic file name prior to uploading. For best printed results, set resolution at 150 dpi or higher.

Contact/Billing info (internal use only)
*Your Name:
*Your Phone:
*Your Email:
Name on Card:
Street Address associated with card:
City, State, Zip:
For security purposes, we'll connect by telephone for your credit card information.

COMMENTS: Kindly let us know how we may be of additional assistance.

Consider expanding your reach by advertising to our readers in the Naples and/or Palm Beach's editions of Natural Awakenings. We would be delighted to send you a quote.

Form Notes appear BELOW the Green "Submit" box.