Please fill out the following form and follow instructions to the right.

Company Name
Your Name *
Street Address *
city *
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zip *
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$5.00 for United States shipment $7.75 for International shipment
   

If paying by cash, check or money order, Fill out form, print and send payment to

NiftyAd.com
1217 Keifer Street
Dayton, Ohio 45404

If paying by credit card, select a shipping location from the dropdown menu below and then click the
"buy now" button.