Personal Information

Name

First*  

Middle  

Last*  

Maiden  

Business Name (if applicable)  

Contact Information

Street Address 1*  

Street Address 2  

City*  

State*  

Zip*  

Country (if not U.S.)  

This address is my     Home     Work

Telephone  

Email Address*  

School*                 Select…         ARCH         CLAS         COM         EDUC         ENGR         GRAD         GSBA         LAW         MED         NURS         MEDTECH         RES/FEL      

Class Year*  

Ad Information

Will you be submitting camera-ready artwork for your ad as a high resolution CMYK pdf?
    Yes  
    No, I will require design at no additional cost.

Will you be submitting an image or logo for your ad (acceptable formats: .jpg, .eps, .pdf)?
    Yes  
    No

Upload your ad or logo (images need to be high resolution):

Upload your ad or logo (images need to be high resolution):

If you require design, please complete the following:

  Ad Text (up to 30 words)
 

  Additional directions/notes
 

Payment:
    $1,500/year (four issues) for Life Members of the Alumni Association  
    $1,700/year (four issues) for non-member alumni  
    I would like become a Life Member of the Alumni Association at this time for a one-time fee of $400 to receive the discount on this purchase as well as other great lifetime benefits ($1,900; includes ad in four issues and Life Membership).

Learn more about Membership

Please note: You will be contacted about this order within two business days. Prepayment is due in full to complete your reservation. We accept VISA, Mastercard, AMEX, Discover, and personal check.

If you have any problems using this form, or have questions, please contact Katie Feagans at 434.243.9022; .(JavaScript must be enabled to view this email address).

By submitting this order, I understand once my payment is processed, my ad will run in four consecutive issues of U.Va. Magazine, beginning with the next available issue. I understand any content, images or other materials submitted to the University of Virginia Alumni Association will be subject to approval and the U.Va. Alumni Association holds the right to reject or cancel any advertisement at any time.