* All Fields are Required
first name:
last name:
Your email address:
Your phone number:
address:
city:
state:
zip code:
The Fake Ad is:
Please list 3 advertisers you first heard of in The Homesteader (and have or plan to visit):
1.
2.
3.
Is there a business you'd like to see advertised in The Homesteader? If so, what is it?
What articles or topics do you most enjoy reading in The Homesteader?
Please check off all of your pending home improvement projects:
Home Decorating (interior decorator; drapes & blinds; closet organizers)
Home Improvement (fences; painting; lighting; security system; pool)
Home Furnishings (new furniture; rugs; wide-screen TV; home theatre)
Lawn & Garden (gardener; tree removal; snow removal; patio furniture)
Professional Services (dentist; doctor; pediatrician; financial planner)
Personal Services (therapeutic massage; pet sitting/walking; hair salon)
Sports & Recreation (fitness club; golf courses; tennis club; country club)
Children's Services (preschool; daycare; educational programs; music lessons)
Other (new/used car; vacation planning; boats; apparel; toys; books)
If you would like us to provide you with information from our contractor referrals (at
no cost or obligation), please provide your specific areas of interest (blinds &
drapes, fence, shed, pool, landscaper, insurance, attorney, etc.):
MONTHLY PRIZE:
I would like a $50 Gift Certificate from this advertiser:
1st Choice:
2nd Choice:
3rd Choice:
additional comments or feedback:
