First Name: 

Last Name: 

Business Name: 

Phone Number (with area code): 

E-Mail address: 

Type of business (Breeding, Training, Tack etc) Please select the one category under which you would like your listing to be placed

Street address of business: 

City in which business is located: 

County in which business is located: 

State in which business is located: 

Please write your listing in the space below.(If you would like an example, you may want to visit our business directory) . Ads may contain a link to your web site.

Do you want your phone number included in your listing? yes  no

Do you want your street address included in your listing?  yes  no

Do you want your e-mail address included in your listing? yes   no

I would like my listing to appear in the business directory section of the Wisconsin Horseman Web Site for
(please check one)   six months ($32.00) one year ($60.00)

PAYMENT METHOD: 

Your credit card will be charged $32.00 for a six month listing or $60.00 for a 12 month listing. Listings will appear on the    Wisconsin Horseman website in the "Business Directory" section. For your protection, all information is sent through a SECURE server.

I would like to pay using (select one)
Visa    Mastercard

Credit Card Number:

Expiration Date:  Month  01 02 03 04 05 06 07 08 09 10 11 12    Year 02 03 04 05 06 07 08 09 10 11 12

Please enter the following information exactly as it appears on your credit card statement

Full Name - exactly as listed on credit card 

Street Address 

City 

State 

Zip 

If you wish to pay by personal check or money order you may e-mail us your listing (click on the "submit" button without filling in credit card information) However, the ad will not be posted until your check or money order is received. For mailing instructions for your check or money order click here