Business Name:____________________________________________________________________________________
Contact Name:____________________________________________ Phone Number_____________________________
Business Address:____________________________________________________________________________________
E-Mail (leave blank if none)________________________________________________________________________
Business Card or Business Logo Included? Yes or No
Business Website Name (leave blank if none)_____________________________________________________________
Please Circle service requested:
Advertisement - $25.00/year Website Link - $40.00/year
Make checks payable to:
City of Medford
PO Box 127
Medford, MN 55049
Brief Description of your business:
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