VANCOUVER ISLAND DESTINATIONS

                                             Tourism Promotion and Answering Services
                                          P.O. Box 691, Port McNeill BC V0N 2R0       
.                                              
                                               E-mail: info@northislandtours.com

                                    APPLICATION FOR INTERNET ADVERTISING

NAME OF BUSINESS:
BUSINESS LICENSE: Y/N (Town)                                               
CONTACT NAME/TITLE:
MAILING ADDRESS:
STREET ADDRESS:
TOLL FREE TELEPHONE:                                           TELEPHONE:
FASCIMILE:                                                                  CELL:
WEB PAGE:                                                                   E-MAIL:

DESCRIPTION OF BUSINESS and rates:

WEB ADVERTISING                                                                                                                            .

Includes: Contact information, description, web site and e-mail link (January 1 - December 31)

Accommodations: $60.00 plus GST

Tour Operators: Please inquire

WWW.NORTHISLANDTOURS.COM

AUTHORIZATION:

I authorize VID to use pictures provided by my company/web site to promote my products(s)            Yes/No
I authorize VID to use text provided by my company/web site to promote my products(s)                  Yes/No

OTHER:

I am interested in a RECIPROCAL LINK                                                                                         Yes/No

I will pay Vancouver Island Destinations 10% COMMISSION for referrals resulting in a booking      Yes/No

.                                PLEASE MAKE CHEQUES PAYABLE TO C. DOWNING__________________

Operator/Business Representative signature_________________________________ Date ____________

Form Revised Dec 3, 2009                              Back to Promotion Page    or     www.northislandtours.com