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MEMBERSHIP INQUIRY FORM

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Please fill out our Membership  Inquiry Form
No obligation!

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DES MOINES NIGHTLIFE MEMBERSHIP  INQUIRY FORM
Your privacy is guaranteed.  This form is strictly an inquiry.  By
completing this form, you are under no obligation to purchase
any of the services that you are interested in. 
We will respond to all inquiries within 24 hours.  If for some
reason you do not feel comfortable filling out this form, you
can e-mail us or call our office at (515)-285-9805  (This is
a local call from the Des Moines area.)
Thank you for your interest!

 

I am interested in:   

          FREE LISTING ON DES MOINES NIGHTLIFE SITE:

  •   I want to be listed FREE on the Des Moines Nightlife    Web Site (business name, address, phone number.)   I understand there is absolutely no charge for this service. Please complete information below and submit this
    form so we can list your business or organization for
    free.  Thank you!  

  • I also want a link to my web site for only $10 per month, payable in one annual installment.  (When completing form below, be sure to include your web site address.)

     DES MOINES NIGHTLIFE
MEMBERSHIP PROMOTIONAL PACKAGES

  • I am interested in assistance in creating a
          site that will be linked to my listing. 
          (Des Moines Nightlife will create site
          absolutely free.  Once you approve your site, you pay
           only a nominal hosting fee of only $20 per month
          (payable in annual installment).

  • I am interested in a Silver Banner Ad ($5 per month,
          payable in annual installments).

  • I am interested in a Gold Banner Ad, ($7.50 per month,
          payable in annual installments).

  • I am interested in a Platinum Banner Ad, ($10 per month,
          payable in annual installments).

       Category of my business (restaurant, sports bar,
       special events, etc.:)

                 

                   The name of my business is:  

                 

       My name is:  

           Title and/or position:  

                  Street Address of my business:     

 

  City:     State:     Zip: 

        Daytime Phone Number:  

        E-Mail: 

        Fax:

        Web Site Address: 

        I prefer to be contacted by:  Phone     E-Mail

Questions and/or Comments:

Take Me To The Top Of This Page.

I Want To Go Back To The Page That Explains The Five Memberships