Advertising Reservation/Insertion Order Form

Complete this form to reserve advertising space in AMSA’s member communications and request information on ways to connect with AMSA members. Refer to the AMSA Media Kit for specifications and rates, which can be found in the Specs & Submission Forms section at amsa.org/workwithus. Submit all ad creative to this form now or to the AMSA Ad Creative Submission Form on or before deadline dates given when placements are confirmed. If you have questions or need assistance, contact sales@amsa.org.

Section 1: Client Contact Information

Section 2: AMSA Website-AMSA.org

Complete this section to reserve digital ad space on AMSA's website. A reservation for at least two months is required. Ad specifications and rates for placement can be found in the AMSA Media Kit by visiting the Specs & Submission Forms section at amsa.org/workwithus.

Select or enter value
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Include price from Media Kit or "pending" if placement is a reservation yet to be secured.

Section 3: Weekly Consult

Complete this section to reserve digital ad space in AMSA's e-newsletter. A reservation for at least one three-month cycle is required. The med+ edition is sent to medical students, residents, and practicing physicians. The premed edition is sent to premedical students. Ad specifications and rates for placement can be found in the AMSA Media Kit by visiting the Specs & Submission Forms section at amsa.org/workwithus.

For selected edition, indicate the ad space type, number of months, date range for ad placement and price based on the rates found in the Media Kit or offered by AMSA in a multi-reservation package.

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Include price from Media Kit or "pending" if placement is a reservation yet to be secured.

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Include price from Media Kit or "pending" if placement is a reservation yet to be secured.

Section 4: The New Physician (TNP)

Complete this section to reserve digital ad space in AMSA's member magazine and electronic table of contents (etoc). A reservation for at least two issues is required. TNP's editorial calendar, ad specifications, and rates can be found in the AMSA Media Kit by visiting the Specs & Submission Forms section at amsa.org/workwithus.

For each issue, indicate the volume year, ad space type, and price based on the rates found in the Media Kit or offered by AMSA in a multi-reservation package.

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Select one.

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Include price from Media Kit or "pending" if placement is a reservation yet to be secured.

Select one.

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Include price from Media Kit or "pending" if placement is a reservation yet to be secured.

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Include price from Media Kit or "pending" if placement is a reservation yet to be secured.

Select
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Select
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Include price from Media Kit or "pending" if placement is a reservation yet to be secured.

Select or enter value
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Select
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Include price from Media Kit or "pending" if placement is a reservation yet to be secured.

Section 5: Other Ways to Connect

To receive more information, check all that apply or copy and paste the URL provided into your Internet browser.

alliance.amsa.org

amsaconvention.org

amsa.org/members/institutional-partners

infocusmarketing.com/lists/amsa

Please indicate type of communication below. AMSA will contact you for more information.

Include any question or comment for AMSA to review and respond to prior to finalizing reservation.

Section 6: Payment Method or Invoice Request

Payment Method or Invoice Request*

Payment Method - Direct Deposit

Direct Deposit: Form Type

If payment method will be made by direct deposit, wire or automated clearing house (ACH), an authorization form is required. Please indicate whether the funds will be coming from a bank in the United States (domestic) or outside of the United States (international) and to whom the form is to be sent.

Payment Method - Check

Provide the date when the check will be or has been mailed to AMSA, 1390 Chain Bridge Road, #A130, McLean, VA 22101.

Invoice Request

Please provide the email to where the invoice is to be sent and the proper bill to entity and mailing address once reservation is finalized with AMSA.

Select proper bill to entity.

Section 7: Authorization

I, hereby, acknowledge that I am authorized on behalf of the Client as indicated on this form to complete and submit this reservation form/insertion order. Acceptance of this reservation does not waive the right of AMSA to reject reservation.

Click here to read the Terms and Conditions.Please check the box to indicate that you have read, understand, and agree to the Terms and Conditions.

Optional: Ad Artwork Collateral Submission

If you have ad artwork ready to upload, feel free to upload file and provide linking URL. Otherwise, please upload ad artwork file and provide linking URL through the AMSA Ad Creative Submission Form on or before deadline dates given when placements are confirmed.

Drag and drop files here or

Thank you for completing this form to reserve your ad space in AMSA's member communications. AMSA will review your reservation and when approved will send you a confirmation email with additional information regarding your advertising placement.

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