Hwc-md.org - Washington Hispanic; Washington, Maryland, Virginia

Name: (Yam)
Company: (Company)
Direction: (Address)
City: (City or Town)
The State: (State)
ZIP code: (Zipcode)
Phone: (Telephone)
e-mail:
Has he published previously? (Have you ever published before?)	If Not
Section: (Section)	Sale / service Work places Revenue

Now we need that it provides the text to us for his notice including a small title of the same one (as it appears in the example of the top part), as well as the phone of the same one or some another fact that he wants to stand out (60 words, maximum).
Title of the Service (name, etc.): (Title of AD)
Text for the body of the notice: (Body of the AD) (Small letters) (Low marries) (60 words like maximum)
Phone or another fact to be emphasized:
Number of weeks that he wants to publish (# of weeks you wish to publish)