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

Company

Company: Contact Name

Company: Contact Title

Company: Contact Email

Company: Contact Phone

Agency

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.

Website: Package Option

Website: # of Months

Website: Start Date

mm/dd/yyyy

Website: End Date

mm/dd/yyyy

Website: Price $

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.

Select Edition

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.

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.

TNP Select Issues

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.

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.

AMSA Alliance Organization Membership

alliance.amsa.org

AMSA Convention & Exposition

amsaconvention.org

AMSA Institutional Partnership Sponsorship

amsa.org/members/institutional-partners

Rent AMSA's Member List

infocusmarketing.com/lists/amsa

Other Communication Vehicle

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

Type of Other Communication Vehicle

Questions/Comments

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

Credit Card (Accounting will reach out to process payment)

Direct Deposit (Please indicate the authorization form type and the email to where form is to be sent.)

Check (Please provide date when check will be mailed or has been mailed.)

Invoice Request (Please include the bill to email, proper entity, and mailing address for invoice request.)

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.

Authorization: Name

Authorization: Title

Authorization: Email

Authorization: Agreement

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.

Authorization: Date

mm/dd/yyyy

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.

File Upload

Drop your files here

Linking URL

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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