Please fill out all fields or we won't be able to process your request.

Your Name:
Address:
City:
State:
Country:
Zip/Postal Code:
Email address:
Phone Number:
Fax Number:
Credit Card Type:	--Select-- Visa Mastercard
Card Number:
Expiration Date:
3-digit Security Code:	(CVV2 code. What is this?)
Name as Printed on Card:
Credit Card Billing Address: City: State: Zip:
How many weeks would you like the ad to run? (Minimum 4 weeks):
What date (begin Monday) would you like your ad to start? --Select-- January February March April May June July August September October November December --Select-- First Week Second Week Third Week Fourth Week (Please allow 72 hours advance notice. All classified ads must be recieved no later than Thursday of the week previous in order to be posted by the following Monday.)
Cost: $20 per week, 4 weeks minimum.
Number of Weeks: x $20 = ORDER TOTAL:
Select a category for your ad: --Select-- Employment Personals Services For Sale Rentals Real Estate Wanted to Buy Miscellaneous
If you wish to include an image with your ad please attach a GIF or JPEG image file and email to: webmaster@bajalife.com Or send a non-returnable camera-ready hard copy image to: Baja Life Online P.O. Box 4917 Laguna Beach, CA 92652 Phone: (949) 376.2252 Fax: (949) 376.7575
I will send an image via Email. I will send an image via the postal service. I do not wish to include an image in my ad.
Text of Classified Ad:
Remember: Type the text of your ad exactly as you wish it to appear. Include your email address, phone number or address in your ad. If you need further information contact us at admin@bajalife.com