Motel-Coupons.com Printable Form

Motel-Coupons.com Listing Template

Please Fill Out All Applicable Fields.
After Your Coupon is Published You Can Use PayPal for Credit Cards

Standard Plan 149.00 Annual
Plan With Photos 199.00 Annual
Plan With Photos and State Banner 299.00 Annual

FAX NUMBER - (352) 685-1040
(Data Line Only, No One Will Answer)
Please Circle A Plan Above

Property Logo or Name ↓	____________________________ Street Address ↑	____________________________ City, State, Zip ↑
	____________________________ Interstate & Exit (Optional) ↑	____________________________ Fax Number ↑
	____________________________ Local Phone Number ↑	____________________________ Toll Free Phone Number ↑
	____________________________ URL ↑	____________________________ Email ↑

Spring Rate ↑

Summer Rate ↑

Fall Rate ↑

Winter Rate ↑

Amenities ↓ (Limit 6)

Based on availability, not valid with other discounts

FAX NUMBER - (352) 685-1040

_______________________ ________________ ______________
Authorizing Signature Print Name FAX Number

Invoice/Ad Proof Will Follow
Credit Card, Debit Card, E-check Payment Accepted Through PayPal.

Motel-Coupons.com
PO Box 1256
Ocala, FL 34478