Step 3. Fill out and submit the form to advancis (all information is required).

 PERSONAL INFORMATION
Note: advancis customers who do not wish to enter new information can simply provide their customer number. Our staff will complete your order form using the data (including PIN and password) provided during your previous order(s).


Last Name First name
Title Company
Address
City State
ZIP Country
Email Web site
Phone Fax
Customer number    

 PRESS RELEASE INFORMATION

Distribution date  

Press release copy  

Category  Please select a category for your press release
 
Technology Entertainment Financial
Internet/Multimedia
Hardware
Software
Networking
 
Movie
Television
Music
Game/Interactive
Earnings
IPOs
Mergers

Press contact info  
 
Name  
Title   
Email address    
Phone  

 IDENTIFICATION

Please select a PIN and password to access restricted sections of the advancis.com web site. Choose 3 to 8 characters, using only A-Z, a-z, and 0-9. Write it down for your records. Note: current customers do not have to enter a new PIN or password.

PIN Password


 PAYMENT INFORMATION

Please note that this is a credit-card only service. The fee per release is US $385.

Credit card  


  Credit card number  
  Cardholder's name  
  Expiration date  
  Card verification number Click on icon for details
  Issuing bank