Please provide the following billing and contact information:

Fields followed by an asterisk are required.

First Name:	*
Last Name:	*
Title:	*
Organization:	*
Address:	*
Address (cont.):
City:	*
State:	*
Zip Code:	*
Phone:	* ...000-000-0000
E-mail:	*
List under:	If physical location is different than billing address information shown above, please complete the following so that your listing will appear in the correct area:
Address:
City:
State:
Zip Code:
County:	*
Region	- Select Region - Atlanta Metro Area Georgia Coastal Region of Georgia Historic South Georgia North Georgia Mountains Southwest Region Georgia Costal North Carolina Great Smoky Mountains - NC North Carolina High Country North Carolina Piedmont Western North Carolina Coast of South Carolina Heartland of South Carolina Upcountry of South Carolina East Tennessee Great Smoky Mountains - TN Middle Tennessee West Tennessee Blue Ridge Highlands - Southwest Virginia Central Virginia Costal Virginia Northern Virginia Shenandoah Valley Eastern Panhandle West Virginia Hatfield - McCoy Mountains West Virginia Metro Valley West Virginia Mid - Ohio Valley West Virginia Mountain Lakes West Virginia Mountaineer Country West Virginia New River/Greenbrier Valley West Virginia Northern Panhandle West Virginia Potomac Highlands West Virginia Maryland Kentucky *

Enter the URL of the site you are submitting: *

  *

(Please do not use all caps.)
Tip: Use Microsoft Word to type and size your listing using the Tools - Word Count... menu option,
then copy and paste it into the Listing box below.

Featured Listing Information: Rate: $140.00 per year, payable annually within 30 days of invoice date.
- Select Page Category - Arts and Crafts Attractions Auctions B & B Inns Biking Cabin Care Cabins/Rentals Calendar of Events Camping/Outdoors Canoeing and Tubing Crafts Fishing Genealogy Golfing Hiking Horseback Riding Hotels/Motels Museums Mountain Music Native Americans Publications Real Estate Recipes Resorts Shopping Skiing Storytelling Theaters Travel Information Travel Planning Universities Weddings Whitewater Rafting Wildflowers Wineries
Type or paste your listing in the space below. Featured Listings are limited to 500 characters or spaces.
	Featured Listings can appear under as many categories as you choose to purchase. Discounts are available for multi-category purchases, contact our sales staff at sales@blueridgeonline.com, to discuss your multi-category needs.

Complete the following to place your brochure online.
Click here to learn more about our Online Brochure program.

Would you like for us to place your brochure online?                                        No Yes *

  - Select how we should create your brochure here - Create it with information from my website I will mail you a copy of my brochure I will email you the artwork and copy

- Select Brochure Size Here if you have a Featured Listing - 2 Panel Brochure with Featured Listing - $30 Hosting - Setup Fee is Waived 4 Panel Brochure with Featured Listing - $30 Hosting - Setup Fee is Waived 6 Panel Brochure with Featured Listing - $30 Hosting - Setup Fee is Waived 8 Panel Brochure with Featured Listing - $40 Hosting - Setup Fee is Waived 10 Panel Brochure with Featured Listing - $50 Hosting - Setup Fee is Waived

	Billing Information
Online Credit Card payment can be made via Pay Pal. Pay Pal no longer requires you to have an account with them for payment. If you would prefer to use this method we will send you an invoice via e-mail to make your secure payment. Please put in comment box Credit Card Payment.
Purchase order #:
Total Amount:	* ... Do not enter $ sign.
Please include Feature Listing fee of $140 plus Brochure and Panel Size fee if you elect to place your brochure online.

You will be billed Net 30 within 10 days for your order.

Enter comments or special instructions below: