New York State Volunteer Ambulance and Rescue Association
New York City Region, District 4
2016 EMS Week Recognition and Memorial Dinner
JOURNAL AD ORDER FORM
[_____] $200.00 Full Page
[_____] $125.00 Half Page
[_____] $ 75.00 Quarter Page
[_____] $ 50.00 Business Card
[_____] $ 25.00 Booster
Please attach a copy of your camera ready ad or a business card. Also, please
e-mail an electronic copy of your ad to
To guarantee your ad is published in the journal, please be sure to have your ad copy submitted by April 1, 2016 at the latest.
Phone: (_____) _____-__________
Please make checks payable to: NYSVARA, NYC Region District 4.
Print page, complete, enclose check and return to:NYSVARA NYC Region District 4
The Dinner Chairperson is Mr. Martin
Grillo, Chief of Emergency Medical Rescue of NYC. He can be contacted at (718) 474-0680. email@example.com
The New York State Volunteer Ambulance & Rescue Association was established in 1939 and is a 501 [ c] [ 3] organization.
Were on the web at www.nysvara.org