Northway Advantage

All submissions must be received by: August 31st, 2009.

Company Name: (As you would like it to appear)
Telephone:
Web Address:
Company Contact:
Primary Business Address:
City:
State:
Zip Code:

Description of Offer: Characters Left

Description of Second Offer: (Optional): Characters Left

Include second offer on:

Upload Your Company's Logo
Please include an electronic copy of your company’s logo with this form. EPS are preferred; however, AI, TIFF, or PDF are also acceptable formats.

Northway Bank reserves the right to:

1. Exclude any offer that it terms unsuitable for the Advantage: Northway Book.
2. Cancel the production of the Advantage: Northway Book if there is a limited response from businesses wanting to be included.
3. Reproduce the company’s name and offer only, if no company logo is supplied or if the supplied logo is in an unusable format.

By accepting these terms I understand that I am:

1. Participating in the Advantage: Northway Book, which is only open to existing business customers of Northway Bank.
2. Authorizing Northway Bank to feature the promotional offer(s) described above in their upcoming 2009 Advantage: Northway Book.
3. Agreeing to honor any coupon from the Northway: Advantage Book that bears my company’s offer(s) redeemed at my place(s) of business through 9/30/10.
4. Agreeing to a maximum print quantity of 25,000 Advantage: Northway Books in which my company’s offer(s) is featured.
5. I will not be receiving a final layout of the 2009 Advantage: Northway Book before its printing.

Name:
Title:
Email:
By selecting "I Agree" you are agreeing to the above terms and conditions of this offer and are confirming that all information on this form is correct.

Northway Bank assumes no responsibility or liability for the performance or quality of the company’s featured product or service. Any customer dissatisfaction with the company’s product or service is the sole responsibility of the company to address and rectify.

Please agree to the terms and conditions above.