Eugene Magazine Retail Guide Submission Form

Contribute to Eugene Magazine's online Retail Guide

Please fill out the following form to add your listing to our online Retail Guide. Please contact us at trisha@eugenemagazine.com with any questions. Thank you for your participation!

Note: responses may be edited for grammar or length.

Question Title

1. Please enter your contact information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

2. Would you like the online Enhanced Retail Guide membership with a link to your website, that will accompany Eugene Magazine’s e-book for $50/monthly (automatic credit card payment). (Required.)

Yes, I would like the enhanced online Retail Guide listing for $50 a month, which will include a photo and my website URL and a listing in the e-book

No, I don't want a membership

I would like more information about the Retail Guide Membership.

Question Title

3. If you answered "Yes" to the previous question, please send a horizontal photo to trisha@eugenemagazine.com

Done

I will do this after I complete this form

Question Title

4. Business Hours

Question Title

5. Type of Merchandise sold

Men's Apparel

Women's Apparel

Apparel

Kid's Apparel

Accessories

Jewelry

Shoes

Luxury

Department Store

Health

Beauty

Travel

Toys & Games

Pet

Arts & Entertainment

Electronics

Recreation

Locally Made

Wedding

Gift

Service

Athletic ware

Florist

Yard/plants

Bridal

Automotive

Other (please specify)

Eugene Magazine Retail Guide Submission Form

Contribute to Eugene Magazine's online Retail Guide

Question Title

1. Please enter your contact information

Question Title

2. Would you like the online Enhanced Retail Guide membership with a link to your website, that will accompany Eugene Magazine’s e-book for $50/monthly (automatic credit card payment). (Required.)

Question Title

3. If you answered "Yes" to the previous question, please send a horizontal photo to trisha@eugenemagazine.com

Question Title

4. Business Hours

Question Title

5. Type of Merchandise sold

Question Title

6. Please provide a short description of your business.

Question Title

7. Anything else you would like to add?

Eugene Magazine Retail Guide Submission Form

Contribute to Eugene Magazine's online Retail Guide

Question Title

* 1. Please enter your contact information

Question Title

* 2. Would you like the online Enhanced Retail Guide membership with a link to your website, that will accompany Eugene Magazine’s e-book for $50/monthly (automatic credit card payment). (Required.)

Question Title

* 3. If you answered "Yes" to the previous question, please send a horizontal photo to trisha@eugenemagazine.com

Question Title

* 4. Business Hours

Question Title

* 5. Type of Merchandise sold

Question Title

* 6. Please provide a short description of your business.

Question Title

* 7. Anything else you would like to add?

1. Please enter your contact information

2. Would you like the online Enhanced Retail Guide membership with a link to your website, that will accompany Eugene Magazine’s e-book for $50/monthly (automatic credit card payment). (Required.)

3. If you answered "Yes" to the previous question, please send a horizontal photo to trisha@eugenemagazine.com

4. Business Hours

5. Type of Merchandise sold

6. Please provide a short description of your business.

7. Anything else you would like to add?