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    Commercial Ad Sales

    Please fill out the form below so that we can build the contract based on the proposal that you recieved and agreed with.

    1. Name/Nombre
    2. Business/Organiztion Name
    3. Website / Pagina de Internet
    4. Point of Contact (if different from above)
    5. Address
    6. City
    7. State / Estado
    8. Zip Code
    9. Phone Number
    10. Email
    11. Plan Interested in:
    12. Please indicate payment Method:
    13. When are you ready to move forward on this? What contact information do you want made public 0-3 weeks4-12 weeks4+months
    14. Do you have a Facebook Page?
    15. Terms: The following information is truthful and I am authorized to enter into a contract with Nueva Vida Media LLC representing the company aforementioned. I understand payments must be made PRIOR to any airing of commercial spots or produced programing. Checking the box indicates agreement of terms.

    Thank you for filling out this form - in a few days you will receive an email from our accounting team with the contract and if needed in that contract will be how and where to upload and programs or commercials. NOTE any credit card charges will incur a 3% convenience fee - bank checks or electronic check payments are free.