Required fields are marked with asterisks (*)

Digital Gateway Sign Request Form

All advertisements will run a minimum of 5 seconds per 3 minutes for 20 impressions per hour and will run for 30 days.
All applications for advertisments must be submitted 30 days prior to the start of the advertisement.
Successful applicants will recieve a proof of their advertisment for approval.
Advertisements will run 24 hours a day 7 days a week equaling approximately 14,000 impressions.

Organization Name

Your Position with Organization

Contact Person

Address

Daytime phone #

Email Address

Type of company

Registered Non-profit group ($114+HST)

Registered Amherstburg Business ($221+HST)

Artwork submission

I will need the Town of Amherstburg to create the artwork.

I will be supplying the artwork. (The Electronic Signs are 5'3" high by 11'9" wide, therefore the image or logo height to width ratio is 100:225. Acceptable file formats are PNG, JPEG, BMP, AVI, MP4, MOV, or Daktronic VMPF files.)

Approximate date to be put up

Approximate date to be taken down

It is understood that my agreement below acknowledges that I have read, understand and agree to Terms & Conditions (which are herein and on reverse side of this Contract by reference) and that I accept and agree to abide by the said Terms & Conditions.

I understand, accept, and agree to said terms of the aforementioned agreement.

Your Signature

Clear

Your First & Last Name

Date of Agreement

The personal information on this form is collected under the authority of the Municipal Act, as amended. The information is used for the purpose of processing this application and administering the legislation.

Forms

Digital Gateway Sign Request Form