Lines Available Advertising

Looking for Reps?
You may wish to utilize our "Lines Available" Service!

Note: If you do not have a website, you may submit literature in the form of a pdf file along with your ad.

Line Available Ad Fee:
$200 - non HIRA members.
Free – HIRA members (one per membership year)

***If you wish to make an additional ad posting within your membership year, contact the HIRA office for pricing. Payment is required for processing. After completing the form, click submit to proceed to Pay Pal and process your payment.

Company Name *

Address *

City *

State or Province *

Zip + 4 *

Phone Number *

Fax Number

Work Phone

E-mail Address *

Website Address

Person to Contact *

Title

Product Description: (100 Words or Less) Please write a description of your company and product that best describes the value to the consumer and Independent medical reps.

Who is the product marketed to?

Commission Rate

Does this line have existing business? Yes No

Does this line need to be pioneered? Yes No

Payment HIRA Member - Ad placement is free.
Nonmember - I will pay by credit card.

Please enter the characters shown.

Thank You!

Thank you for completing the application. The ad will be posted in the Members Only section of the HIRA website for a 4 week period. The Reps will contact you directly if they are interested in your line.

Payment

The cost of this line ad is $200. HIRA members receive 1 free ad per membership year. If you are not a HIRA member, please contact the HIRA office at 303-756-8115 to pay by credit card or use the PAY NOW button below to pay through PayPal and complete your transaction.

Act now to acquire the best Reps available!