Business name __________________________
Your name ______________________________
Address ________________________________
_______________________________________
_______________________________________

Voice phone ___________________
Fax __________________________
E-mail address _________________
Web site _______________________
Business hours __________________
Description of services or products (maximum 300 characters) __________________________
           __________________________________________________________________________
           __________________________________________________________________________

Are you a JPFO member? _____
Do you want your listing to show that you are a current member of JPFO? _____
All incoming listing forms are checked against JPFO membership rolls.

____ Discover Card, ____ VISA, ___ MasterCard, ____ American Express
Credit card number ______________________________
Expiration date _________________________________
Name on credit card _____________________________
Billing address of credit card _______________________

Print out this sign-up form, type or neatly hand-print your listing and it fax to 1-262-673-9746 with your credit card information, or mail to the address at the top of this page with your check, money order, or credit card information.