Print This "Show/Event Form" & Mail or Fax In

Name:______________________________________

Address:_____________________________________

State:__________ Zip:__________   Phone:___________________

Check - Money Order - Credit Card Visa/MC -------$20 per Issue (see issues below)

Credit Card #:_____________________________________   or  Check #:____________

Card Exp:_____________     Amount to charge your card: $________


 Event Name:_____________________________________________________

Event Date:________________  Event Phone:________________

Event Info:_______________________________________________________

________________________________________________________________

_______________________________________________________________

Which issues want event listed in? (Circle): Oct/Nov Issue - Dec/Jan Issue - Feb/March Issue - 

April/May Issue - June Issue - July Issue - Aug/Sept Issue  ($20 per issue)

Your event will be listed in print and on-line /Please include a show flyer if you have one!

Send to: Gearhead News - P.O. Box 475, Lemont, IL, 60439

Phone 630-427-0409    Fax 630-985-8725

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