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<meta content="The Web site of The Power Marketing Association offering news, training and information for the new, competitive electric power industry." name="description">
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<title>PMA OnLine Energy Classifieds Free Registration Form</title>
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    <td align="left" noWrap vAlign="top" width="108" bgcolor="#0000A0"></td>
    <td align="left" vAlign="top" width="426"><form method="POST" action="../_vti_bin/shtml.dll/classified/clasform.htm" onSubmit="" webbot-action="--WEBBOT-SELF--">
      <!--webbot bot="SaveResults" startspan
      U-File="../_private/form_results.txt" S-Format="TEXT/CSV"
      S-Label-Fields="TRUE" B-Reverse-Chronology="FALSE"
      S-Email-Format="TEXT/PRE" S-Email-Address="[email protected]"
      B-Email-Label-Fields="TRUE" B-Email-Subject-From-Field="FALSE"
      S-Email-Subject="PMA OnLine Classifieds"
      S-Builtin-Fields="REMOTE_USER HTTP_USER_AGENT"
      U-Confirmation-Url="../pma/clscfrm.htm" --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot
      bot="SaveResults" endspan i-checksum="43374" --><div align="center"><center><p><font
      size="2"><img src="http://www.powermarketers.com/images/clsfd2.gif" hspace="5" vspace="5"
      width="393" height="98" alt="PowerMarketers.com Energy Classifieds"></font></p>
      </center></div><div align="center"><center><table border="0" cellPadding="3" cellSpacing="0" width="472">
<tbody>
        <tr>
          <td width="436"><div align="left"><p align="center"><font size="4" color="#003366"><strong><b>PMA
        CLASSIFIED INSERTION ORDER FORM</b> </strong></font></p>
      </div><p><font size="2">The following advertising insertion contract is subject to the
      PowerMarketers.com Classifieds <a href="http://www.powermarketers.com/classrate.htm">standard
      classifieds rates, terms and condition</a></font></p>
      <div align="left"><p><font size="2">(Please Complete all of the Fields)</font></p>
      </div>
      <div align="left">
        <div align="center">
          <table border="0" cellpadding="5" cellspacing="0" width="468">
            <tr>
          <td colspan="2" bgcolor="#C0C0C0" valign="middle"><font size="2"><b>CUSTOMER INFORMATION</b></font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">First Name:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="a. First Name"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Last Name:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="b. Last Name"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Title:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="c. Title"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Agency:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="d. Agency"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Company:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="e. Company"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Department:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="f. Department"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Street Address:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="g. Street Address"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">City:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="h. City"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">State:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="i. State"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Zip / Postal Code:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="j. Zip - Postal Code"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Country:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="k. Country"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Phone:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="l. Phone"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Fax:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="m. Fax"><br>
          </font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Email:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="n. Email"><br>
          </font></td>
            </tr>
            <tr>
          <td colspan="2" bgcolor="#C0C0C0" valign="middle" width="150"><font size="2"><b>AD
          INFORMATION</b></font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"></td>
          <td width="318"></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Ad Package (<i>required</i>):</font></td>
          <td width="318"><font size="2"><select name="o. Ad Package" size="1">
            <option selected>Click Arrow - Select From Pull-Down Menu</option>
            <option value="Basic Contract">Basic Contract</option>
            <option value="Contract A">Contract A</option>
            <option value="Contract B">Contract B</option>
            <option value="Contract C">Contract C</option>
            <option value="Free 30 Day Trial (New Advertisers OnLy)">Free 30 Day Trial (New Advertisers OnLy)</option>
          </select><br>
            <a href="http://www.powermarketers.com/classrate.htm">Ad Rates/Specifications</a></font></td>
            </tr>
            <tr>
          <td valign="middle" width="150"><font size="2">Contract Term:</font></td>
          <td width="318"><font size="2"><select name="p. Contract Term" size="1">
            <option selected>Select One:</option>
            <option value="One Month">One Month</option>
            <option value="Two Months">Two Months</option>
            <option value="Three Months">Three Months</option>
            <option value="Other">Other</option>
          </select></font></td>
            </tr>
            <tr>
          <td width="150" height="25" valign="middle"><font size="2">Promotion Start Date:</font></td>
          <td width="318"><font size="2"><input type="text" size="30" name="q. Promotion Start Date"></font></td>
            </tr>
            <tr>
          <td valign="middle" width="150" height="25"><font size="2">Alternative
            Ad Delivery Method:</font></td>
          <td width="318"><font size="2"><input type="radio" name="r. Delivery" value="E-Mail"><a
          href="mailto:[email protected]">Email Attachment</a><br>
            </font></td>
            </tr>
            <tr>
          <td valign="middle" width="468" colspan="2"><font size="2">Insert
            Classified Ad Copy In This Box:</font></td>
            </tr>
            <tr>
          <td width="468" height="25" valign="middle" colspan="2"><font size="2"><textarea name="s. Comments_Box"
          rows="6" cols="50" wrap="physical"></textarea></font></td>
            </tr>
          </table>
        </div>
      </div></td>
        </tr>
        <tr>
          <td height="25" valign="middle" width="480"><font size="2"><input
          type="checkbox" name="t. Contact me concerning other opportunities" value="Yes">Please
          contact me concerning other advertising opportunities. </font></td>
        </tr>
        <tr>
          <td width="436" bgcolor="#FFFFFF"><p><font size="2"><b><font color="#0000FF">Attention Advertisers:</font></b>&nbsp;&nbsp;</font></p>
      <ul>
        <li><font size="2">After clicking the &quot;Submit Ad&quot;
          button below, please allow up to 60 seconds for your information to be
          processed.&nbsp;&nbsp;&nbsp;</font></li>
        <li><font size="2">A confirmation page will appear in your browser once
          your order has been received.&nbsp;&nbsp;</font></li>
        <li><font size="2">Orders for immediate posting will be posted within 24
          hours of receipt.</font></li>
      </ul>
          </td>
        </tr>
        <tr>
          <td width="436" bgcolor="#FFFFFF">
          <div align="center"><center><table border="0" cellPadding="0" cellSpacing="0" width="472">
<tbody>
            <tr>
              <td bgcolor="#FFFFFF"><p><input name="Submit1" type="submit" value="Submit Ad">&nbsp;&nbsp; <input name="Reset1" type="reset" value="Reset">
                <p>&nbsp; </td>
            </tr>
            <tr>
              <td bgcolor="#FFFFFF"><h1 align="center"><strong><font face="Tahoma"><font
    color="#FF0000">PMA</font> OnLine</font><br>
    <font face="Tahoma" size="2" color="#808080">www.powermarketers.com</font></strong></h1>
    <div align="center"><table border="0" cellpadding="0" cellspacing="0" width="460">
      <tr>
        <td colspan="3" valign="bottom" width="460"><font size="1"><p align="center"></font><font
        color="#001D62"><strong>Table of Contents</strong></font></td>
      </tr>
      <tr>
        <td colspan="3" valign="bottom" width="460"></td>
      </tr>
      <tr>
        <td width="153"><a href="http://www.powermarketers.com/power2.htm"><font size="1">PMA
        Daily Power Report</font></a></td>
        <td width="153"><a href="http://www.retailenergy.com/pmamag.htm"><font size="1">PMA OnLine
        Magazine</font></a></td>
        <td width="154"><a href="http://www.powermarketers.com/pmajobs.htm"><font size="1">PMA
        Jobs Site</font></a></td>
      </tr>
      <tr>
        <td width="153"><a href="http://www.powermarketers.com/member~1.html"><font size="1">About
        Membership</font></a></td>
        <td width="153"><a href="../directories/drectory.htm"><font size="1">Industry
        Directories</font></a></td>
        <td width="154"><a href="http://www.retailenergy.com/mailis~1.html"><font size="1">PMA
        Mailing List</font></a></td>
      </tr>
      <tr>
        <td width="153"><a href="http://www.powermarketers.com/pmacon.htm"><font size="1">Upcoming
        Events</font></a></td>
        <td width="153"><a href="http://www.powermarketers.com/links.html"><font size="1">Energy
        Links</font></a></td>
        <td width="154"><a href="http://www.powermarketers.com/adrates.html"><font size="1">Advertising/Exhibits</font></a></td>
      </tr>
      <tr>
        <td width="153"><a href="http://www.powermarketers.com/conslt~1.html"><font size="1">Consulting
        Services</font></a></td>
        <td width="153"><a href="http://www.retailenergy.com/pma/hilites.html"><font size="1">Bulk
        Power Highlights</font></a></td>
        <td width="154"><a href="http://www.retailenergy.com/searchpma.htm"><font size="1">Search</font></a></td>
      </tr>
      <tr>
        <td width="153"><a href="http://www.powermarketers.com/glossary.htm"><font size="1">Power
        Glossary</font></a></td>
        <td width="153"><a href="http://www.powermarketers.com/pmastaff.html"><font size="1">PMA
        Officers &amp; Staff</font></a></td>
        <td width="154"><a href="mailto:[email protected]"><font size="1">Webmaster</font></a></td>
      </tr>
      <tr>
        <td colspan="3" width="460"></td>
      </tr>
    </table>
                </div><p align="center"><a href="#Top"><img align="middle" alt="Back to the Top"
    border="0" src="http://www.powermarketers.com/images/backtop2.gif" width="27" height="23"><br>
    <font size="1">Back to the Top</font></a></p>
    <p align="center"><a href="http://www.powermarketers.com/main.htm" target="_parent"><font
    size="1">PMA OnLine Home</font></a></p>
    <p align="center"><font size="1"><a href="http://www.powermarketers.com/power2.htm">Power
    Report Front Page</a></font> </td>
            </tr>
</tbody>
          </table>
          </center></div></td>
        </tr>
</tbody>
      </table>
      </center></div>
    </form>
    </td>
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Anon7 - 2021