Fanzine Front Page Listing Request Form This form can be used for either fanzine; * www.NEOMN.com * www.surfforlocalmusic.net These fanzines are published by the Eccentric Musician Company. Owner is Glen Peladeau and is PayPal Verified. Please fill in the form below so we can verify the schedule opening and complete your order. This may take a few business days. Due date is the Friday prior to two weeks of the actual placement. Your First Name;* Your Last Name;* Email Address* Phone * Ad Placement Details; Placement fee's are calculated by the day. Our minimum placement is three days. You can buy a slot that fits in from one event to the next. Example; If Joe's event is on a Sunday and yours is on a Thursday. You can buy Monday to Thursday. Is Your Front Page Listing Already Published On the Ezine? Yes, on a sub level page. See below. No, See the event listing below. No, I will attach the review/listing details. What is the header name of your current listing if any; Use the fields below to submit a new listing or music review. All others who currently have a listing or review that would like to have front page exposure can use this section to do so. Eccentric Musician Company reserves the right to approve or deny any listing or review for any or no reason. Enter "From this date" here; Enter "To this date" here; optional; Attach a JPEG picture of your band Artists or Band's Name; * Your relation to artist or band; Artist/band's State of Residence; City of Event; Start Time (List AM or PM): End Time (List AM or PM): Event Details (>150 characters); URL of Artist/Band's Picture for front page lisiting; Please enter the phrase as it is shown in the box above.