TCR Web Insertion Order

IO Number
Today's Date*
Date Format: MM slash DD slash YYYY
Sales Rep
Account No.*
Advertiser*
Ad Size:*
Number of Months to Charge:*
Ad Start Date:*
Date Format: MM slash DD slash YYYY
Ad Stop Date:*
Date Format: MM slash DD slash YYYY
Rate Code*
REG: Regular Rate NPR: Non-Profit Rate
Ad Cost:*
Placement Charge*
Discount Amount*
Individual Ad Order Charge
Total Ad Order Charge*
Authorized by:*
Payment*
Production*
Other information
Send Proof To:*
First Last
Email proof to:*
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