2018 Ad Contract

Print Form

100st Anniversary of Poland regaining its Independence
(Chicago, September 21 – 22, 2018)

Commemorative Program and Abstract Book (Gala and Symposium)

Advertisement Contract


Name of Company/Organization: ___________________________________________
Contact Person: ________________________________________________________
Address: ______________________________________________________________
Phone Number: ________________ Email Address: ___________________________
Ad Rates (please circle one)
Advertisement in Special Edition Gala/Symposium Program Book

☐ Back Cover (8”x10”) – $2500
☐ Inside front cover (8”x10”) – $2000
☐ Inside back cover (8”x10”) – $1500
☐ Full Page (8”x10”) – $500
☐ Half Page – $300
☐ Quarter Page – $200
☐ Business Card (1.5”x3”) – $150
☐ Greetings s – 1 line $100

I cannot attend, please accept my donation of $______________ Total: $______________

Please, be sure to include clean artwork when possible, If you don’t have artwork, write down your greeting card and attach a business card. We will do the ad for you.
Camera ready art also can be emailed in PDF or TIF format once payment has been arranged. We can also use your ads from previous PAMS campaigns that you have generously supported.

Payment methods (for ads and/or donations):
Check # _________________ Cash ______________ Paypal __________________

Visa__ Master Card __ American Express __ for the amount $____________

Credit Card #____________________________ Expiration date_____________

Please return this form along with the payment by August 31, 2018
After filing this contract, please make check payable to the PAMS and mail it to:
PAMS, Marek Rudnicki, MD 3000 N. Halsted, Suite 603, Chicago, Il 60657

If you should have any questions or to pay by phone using your Credit Card, please contact
Bianka (PAMS/Dr Rudnicki office) at 773 296 3838 or email rudnicki@gmail.com
Thank you for your support!
The Polish American Medical Society is a 501(c)(3) charity and any donations or purchases are tax deductible

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