Media Ticket Trade Form

PUBLICATION / TV / RADIO TICKET TRADE AGREEMENT

Media Type

TV/Radio

Ad to run Custom - copy provided, produced by station

If you selected "custom," please provide the length

Number of run times

Value $

Total Value $

PUBLICATION

Please indicate which size ad you would like (Dimensions in Inches ex. _x_)

Please indicate if you'd like the ad to be black and white, or 4 color.

Number of run times:

Value $

Total Value $

While requesting a custom ad, please indicate the deadline

Publication Information

Total Ad Value/Ticket Value (Box Office Price) = Number of Tickets. The maximum number of tickets that can be traded is 300.

Publication

Contact Name

Mailing Address

City

Province/State

Postal Code

Phone

I agree that: Tickets received may not be sold, or handed out at the show site. After the ad has run, a copy will be sent to Marketplace Events.

Yes

Electric Signature

Please type your first and last name

Date

I understand that checking this box constitutes a legal signature confirming that I acknowledge and warrant the truthfulness of the information provided in this document.

Yes

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