SUBSCRIBER INFORMATION Account ID Full Name Firm Address City State Zip Phone (office) Fax Email Email Confirm email Website PIABA Bar Journal I wish to receive the PIABA Bar Journal Online Only I wish to receive a hard copy of the PIABA Bar Journal Total Enclosed $ Membership Directory Ads 1/8 Page (business card size) (3 1/2" wide x 2 1/4" tall) $300 1/4 Page Vertical (3 1/2" wide x 4 7/8" tall) $400 1/4 Page Horizontal (7 1/2" wide x 2" tall) $400 1/2 Page Horizontal (7 1/2" wide x 4 1/2" tall) $800 1/2 Page Vertical (3 1/2" wide x 9 3/4" tall) $800 Full Page (7 1/2" wide x 10" tall) $1050 Center Staple, back, R/F color $1200 Center Staple, back, L/F color $1200 Center Staple, L/F color $1300 Center Staple, R/F color $1300 Inside Back Cover color $1700 Inside Front Cover color $1700 Back Cover color $2050 I do not want to include an advertisement in the PIABA Membership Directory Leave this field blank