Business Listing Form

         New Jersey Lawyer is please to hear that you will be placing a listing in our Guide to Internet Services 2004-2005 to be published Aug. 2. As a bonus, we will also place your listing in our NJLNews Online Service Directory for 3 months. Below is a form we will need to have you complete and fax back to us to reserve space in the guide and directory and to compose your listing.

Please fill out the form below - This is the order in which the information will be printed in the guide. (Note: 'required' indicates a form field that must be completed)

Reserve print and online space for my listing for the one-time fee of $139, paid in advance.

Add my Web site link online for $50
Place under other categories for $70 per listing
Company Information

Select one basic category under which to list your business: (required)
Business Service Legal Service Experts Products

Company Name: (required)

40 word description of your company's services:

Contact Information

Street Address:

City: (required)

State:     Zip code: (required)

Phone: (required)

Email address:

Web link:

Billing Information (all required, unless you pay by check)

Name Authorizing Listing:

Check enclosed (pay to NJ Lawyer)
Charge VISA / Master Card / AMEX

Card Number:

Exp. Date:      Month:       Year:

If you have any questions or problems to report concerning this form, please call 732-650-2864.