Name: Already got my first sign up from your ad!
Rating: 5
Author: Belinda Mendoza

Directory Page Application Form

Please complete the form below with as much information as possible. Required fields are marked with a red asterisk.

Company or Practice Name (one per page listing)*
Please enter your company or practice name as you would like it to be listed on our site.
Your Name*
First Last
Your Email*
Enter Email Confirm Email
Would you like your email to show on your web page?*
- Yes
- No
Phone*
Would you like your phone number to show on your web page?*
- Yes
- No
Your Website
Address*
Street Address Address Line 2 City State ZIP Code
Would you like your address to show on your web page?*
- Yes
- No
Is this address for a residence or a business?*
- Residence
- Business
- Both
Provider Description*
This is the heart of your listing. Please include details to help our readers get to know you and your practice or business. Please note: Your entry should be unique. We cannot accept descriptions that are copied from other websites.
Do you have any certifications that you would like our readers to know about?
Do you have any testimonials or reviews that we can include in your listing?
Usually 3-4 max.
In the news? Include links here...
Have you been interviewed on TV, in the newspaper, a magazine, participated in a podcast or taken calls on a radio show? Share with us your favorite online links to these resources. (Must be a news source, not a link to your own content.) In cases where there aren't links available, please provide a citation including publication, issue, date, title, etc. where we can find it.
Summary*
Brief "elevator" intro to your business and/or services.
Primary Category*
Additional Category
Additional Category
What one thing can you or your business help our readers solve? Please provide a statement.*
This helps me with the social media features we do for your listing.
Social Media
Are you on social media like Facebook, YouTube, Twitter or Google+? If so, please share your links here. (Actual links - please don't expect me to search for them.)
Upload Your Picture or Logo
Square or portrait oriented images only please. Image needs to be at least 200px wide and can have only a little text. Please Note: *No pdf fliers, banners or landscape images.* These are too wide to fit on our website and we will not accept or store them.
Accepted file types: jpg, gif, png.
Are you new to The Austin Alchemist?*
- Yes
- No
How did you learn about The Austin Alchemist?
Notes for Julia
This is an optional space for you to include extra information that I might need for your order - information that might not be covered by the fields above. Things like special circumstances for running your ad on specific dates, etc.. I.e. "I want to pay for my order now, but have my ad run 3 weeks from now because I'm on my way out of town..." Or "I want to run this ad on the 1st Thursday of every month for the next 6 months," etc.. Put all these types of details here for me. I may call you if I have questions. (Note: we can re-feature your directory page in our newsletter more than just once a year. Just contact me for details.)
Would you like to receive our email news feed? It's a great way to keep in touch with what's happening in the spiritual community! It comes out Thursday mornings, just in time for the weekend!
- Yes, I'd like to receive email news including freshly added practitioners and events including classes, lectures and fairs all in the Austin area.
Practitioner and Business Page Submission Fee*
The Practitioner and Business Pages are $39 for the first year and then $10 each year thereafter. The total below reflects this pricing for the first year.
Price: $29.00
Annual Hosting Fee - Practitioner / Business Page
Price: $10.00
First Year Total
$0.00
Phone
This field is for validation purposes and should be left unchanged.

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Directory Page Application Form

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