Company:* Country:
Address:*  Room/Suite/Floor:
City:*  State:*
 
Phone:*  xxx-xxx-xxxx    Zip:*xxxxx
   
Fax:  xxx-xxx-xxxx
 
Contact Name:*
E-mail: name@domain.com  
Title:
Company url:* 
http://www.companyname.com
 
Product and Service Categories
Please indicate in which category(s) your company's listings should appear.
Ordering information on page 2.
*Indicates additional listing opportunities.
 DUE DATE: May 15th, 2011
Don't be left out!!!
Administrative













Equipment
















Furniture & Furnishings







IT & Software
Resident Care






















Safety & Security




ORDERING INFORMATION
Every listing included on our Online Industry Directory at www.mcknights.com
PRINT INFORMATION MUST BE RECEIVED BY MAY 15th, 2011
1 1st Basic Listing (only $60) I want more additional Listing(s) at $80 EACH Your listing includes:Company name, address, phone and fax number, email and web address and contact name, in print and online for 12 months.

Please type in the category # under which your listings should appear: (separate each by a comma)
2 1st Enhanced (only $275) I want   additional Enhanced listing(s)at $180 EACH Listing includes:bold company name, address, phone and fax number, email and web address, contact person, color company logo and a 50-word description in print and online for 12 months.

Descriptive copy about your company (50 words max.):

Please type in the category # under which your listings should appear: (separate each by a comma)
3 1st Power (only $475) I want additional Power listing(s) at $395 EACH Listing includes:bold red company name, address, phone and fax number, e-mail and web address, contact person, color company logo, color block in print on entire listing and a 100-word description, in print and online for 12 months.

Descriptive copy about your company (100 words max.):

Please write in the category # under which your listings should appear: (separate each by a comma)
4  Color Photo $60.00 EACH additional Add a color photo to any listing (approx size 3/4"h x 11/4"w, separate each by a comma):
5 Video Clips $1000.00 Annually 30 second video clip to enhance your online directory advertisements, written by you, produced by us. It will be online for 12 months.
Note: Prices are net.                                                                      Total Amount Enclosed:  
   
Check here for additional Display advertising information.
1. Check mailed to ...
(payable to McKnight's LTCN)
1 Northfield Plaza Suite 521, Northfield, Illinois 60093		 2. Bill my company - address above 3.
NOTE: If you have chosen to pay by credit card, we will contact you for your account information.
For additional information, call or email:
Andrew Riviere at (847)784-8706 x17, andrew.riviere@mcknights.com