"Lines Available" Application - Health Industry Representatives Association

Looking For Reps...

...You may wish to utilize our "Lines Available" Service!

Company Name:
Address:
City:
State:
Zip + 4:
Phone Number:
Fax Number:
E-mail Address:
Website Address:
Literature: If you don’t have a website, you may submit literature in the form of a pdf file along with your ad.
Person to Contact:
Title:

Territory(s) Open: (Check the States and/or Provinces that are open)

Canada:

AB BC MB NB

NF NS NT ON

PE SA YT

U.S.A.

AL AK AR AZ

CA CO CT DE

FL GA HI IA

ID IL IN KS

KY LA MA ME

MD MI MN MO

MS MT NC ND

NE NH NJ NM

NV NY OH OK

OR PA RI SC

SD TN TX UT

VA VT WA WI

WV WY

Product Description: (25 words or less)

Who is the Product Marketed to:

Commission Rate (Disclosure at this time is optional):

Payment:

HIRA member, ad placement is free.

Nonmember - I will pay by credit card

This service is available each month - there is a fee of $95 per broadcast e-mail for nonmembers. Please contact the HIRA Office at (800) 777-4472 to pay by credit card. No cost to HIRA Allied members.

Lines Available listings are broadcast e-mailed to all HIRA Representatives within seven days of submittal.

Act now to acquire the best Reps available!

Health Industry Representatives Association
7315 East 5th Avenue
Denver CO 80230
Phone: (303) 756-8115
FAX: (303) 341-0282
E-mail:
http://www.hira.org