The following information will be used to generate the listing in our Online Directory. 
Current Total:
I require additional assistance and would like a representative to contact me regarding my listing.
The following information represents the person responsible for payment of the listing.  The individual listed below will also have the ability to Edit, Renew, or Cancel your organization's listing in our directory.  Once a listing has been generated, the 'Administrative Contact' will be contacted, via email, to review the listing.

By submitting this form, the 'Advertiser' agrees to the following terms an conditions: Listings purchased will go-live on the website within 48 hours of purchase and will remain visible for one full calendar year, beginning March 1, 2017. Once the listing is live, the Advertiser’s Agent (see below) will be notified, via email. If the option of making 3 payments is selected, subsequent transactions will take place 30 and 60 days from the original date of purchase. Failure to complete said payments will result in the forfeiture of rank (for Featured Listings) and possible removal from the directory. There are no automatic renewals. Prior to the listing’s expiration the Advertiser’s Agent will be contacted. Standard Listings appear in alphabetical order and below Featured Listings in each category. Featured Listings appear in the order they are purchased. By submitting this agreement the Advertiser’s Agent indemnifies Unrelenting Media, Inc., as well as its officers/agents, from any and all liability as it relates to the publication of By submitting this document, the ‘Advertiser’s Agent’ certifies that he/she is a duly authorized agent of the ‘Advertiser’ and has the authority to enter such an agreement. Unrelenting Media, Inc. reserves the right to reject or cancel any advertising order or advertising copy for any reason, at any time. Advertiser agrees to reimburse Unrelenting Media, Inc. for any fees and costs incurred by Unrelenting Media, Inc. (or its agents) in collecting any unpaid charge or portion of the charge for advertisements, including, but not limited to attorney fees and court costs. In the event of errors in or omissions of any advertisement(s), the liability of Unrelenting Media, Inc. shall not exceed a refund of the amounts paid to Unrelenting Media, Inc. for the advertisement. The copyright in any advertisement created by or on behalf of Unrelenting Media, Inc. may not be used by the advertiser without the expressed written consent of Joseph Abraham of Unrelenting Media, Inc.. A digital reproduction of this document shall serve as an ‘original’ document in the event of submission via email or facsimile.  *
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