BMN Press Release Order Page -- www.biomedical-market-news.com/orderpg.html

Welcome Visitor:
To schedule your announcement(s), complete this form, print, and fax to our 24/7 SecureFax™ line: +1 (714) 549-4266
At the same time e-mail your release to our editorial dept at: releases[at]biomedicalnews.org
One of our staff will call or email you within 24 business hrs to confirm your order and schedule your press release
(requests over weekend will be responded to Monday); please allow 24-48 hrs lead time before your announce date; dates are based on availability
Any questions? Call us at +1 714 549-4180 (9:00am to 5:00pm Monday through Friday, PST)
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Section A -- Your Contact Information

Please [type-in] all lines so we can reach you to confirm your order.

◄ Your Name ◄ Position Title
◄ Company / Organization ◄ Company or Mail Address - line 1 ◄ Company or Mail Address - line 2 ◄ Your Phone Number ◄ Your Fax Number ◄ Your Email Address

Section B -- Your Product Order Request

Please select your Medical Industry E-Broadcast™ option:

QTY COST: PRODUCT DESCRIPTION (Click on product for details)

1   $ 499.00    [ 1-Single Press Release, Special Intro Rate]

1   $ 695.00   [ 2-Set Pack, advised for repeat messaging]

1    $ 995.00   [ 3-Set Pack, best plan -- most impressions to market]

     Received another offer? -- enter your promo code in Section C, Payment Due;
     (Your quantity and offer will be confirmed by the promo code)

ABOVE PACKAGES INCLUDE:
                  ● e-Optimize™ -- Copy optimization, deliverability optimization, link checks
                  ● Dynamic URLs directing respondents to your web pagesp
                  ● ViewTrack™ Report (available on certain orders only)

COMPLETE▼:
< JOB NAME #1
< JOB NAME #2
< PREFERRED SEND DATE - JOB 1 (enter as 00/00/2009)
< OPTIONAL SEND DATE - JOB 1 ( in case 1st is booked)
< PREFERRED SEND DATE - JOB 2
< OPTIONAL SEND DATE - JOB 2

If paying by check, remit this order w/your payment payable to:
                             BIOMEDICAL MARKET NEWSLETTER, INC.
                    3237 Idaho Place, Costa Mesa, CA   USA 92626-2207

      Checks must be received (3) business days prior to transmit date.
                 You will receive a payment confirmation by email.

Section C -- Payment Method

Select Your Card - Then complete all lines below
For payments via check or money order see bottom portion of this form

AMERICAN EXPRESS

MASTERCARD

VISA CARD

DISCOVER

◄ Cardholder Name ◄ Credit Card No
◄ Billing Address - Line1 ◄ Billing Address - Line2 ◄ Credit Card Exp Date ◄ Signature (type in)

PAYMENT DUE:
Add Your Cost/Service Option From Section "B":

SUB-TOTAL (enter $499.00; $695.00, $995.00, etc)

Promo Code (if any):

(Calif. billing addresses/clients add 8.75% tax)

◄ TOTAL (add your total here)

If all fields are correct, your card will be charged the amount in 'TOTAL' Box.

Finished? ... Print This Form and Submit To:
Our 24/7 SecureFax™ Line: 1+ (714) 549-4266

Note: Your Printer May Not Display/Print this form correctly based on your printer settings; the printout is acceptable as long as the answer windows are visible.

Receipts: You will receive an e-receipt of your order (receipts do not contain confidential credit card data) to your email address, as well as a confirming e-mail the next business day to schedule your announce date and/or confirm your special offer package. (48) hrs notice required.

Transmit Dates Based on Availability.

Terms: As setup and editing time/labor are allocated to releases before sign-off, pre-payment is required on orders before transmission date.