Kamaaina Discount Submit Advertising Form

Use This Form to Submit A Kama'aina Discount Promotional Advertisement

Refer to How to Place an Ad, then complete this form to submit your ad.

If you want more information about advertising on Kama'aina Discount.com or about securing additional advertising, please and one of our representatives will contact you as soon as possible.

Enter Your Kama'aina Discount Ad

Fields in BLUE (*) are required.

*Company Name:
Company Address 1:
Company Address 2:
*City:
State:
*Zip:
*Select Category:		(click arrow to select the category most applicable.)
*Select Island:		(click arrow to select the island where discount applies.)
*Payment Frequency:	Annual Semi-annual Quarterly Monthly
*Discount Short Description:	(Short description of the discount such as 20% off regular price, $10 off on Mondays, free meal with one meal purchase, etc. 35 characters max.)
*Discount Detailed Description: (500 characters max. - approx. 100 words. Click on Oahu then Accommodations/ More Info for examples. Click browser BACK to return.)
Start Date: (MM/DD/YY)		(when the discount begins)
End Date: (MM/DD/YY)		(when the discount ends)
Discount Location Address:
Discount Location City:
*Phone Number for information or reservations:	Toll Free: (other island access)
WebSite:	Is logo on website? click if Yes
Preferred Contact Method:	(How you would like to be contacted for reservations, info, etc.)
(Optional) Coupon Choice:	Click here to view coupons Use Browser back button to return.
*Contact Name:	(The contact information below will not be included on the promotional ad web page:) (Person placing the ad)
*Title:
*Contact Phone:
*Contact Email:
*Code:
By submitting this advertisement, you are agreeing to the terms of the Advertising Agreement on the kamaainadiscount.com website.

Logo Image: If the url of your website does not contain your logo, attach the image to an email sent to merchant_adrequest