Yellow Springs News
2009 Community Directory
Residential Online Submission Form

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Welcome to the Yellow Springs News Community Directory online submission form.

This year, we can accept your directory listing information electronically. If you submit your information this way, you will not need to fill out and submit a card.

To confirm the receipt of your information, we will contact you at the e-mail provided.

If you do not recieve a confirmation within one week, please contact us by phone at 937-767-7373, or by e-mail at the Yellow Springs News
PLEASE NOTE: • All fields shaded in PINK are required.
• Fields shaded in PEACH are NOT required.
• Address field should be filled out if you wish to include it as part of your listing.
• Although your e-mail is required for us to contact you, it will NOT be included in your listing.
• This transmission is NOT secure;

Please submit only one form per telephone number.

LAST Name
FIRST Name
Enter your E-MAIL
Re-enter your
E-MAIL
(E-mail is for confirmation purposes only; it will NOT appear in directory)
PHONE NUMBER
Re-enter your PHONE NUMBER
STREET ADDRESS
(Fill out only if you would like it included in the directory)
Additional names for directory listing at this number:
1) NAME(last, first)
2) NAME(last, first)
3) NAME(last, first)
4) NAME(last, first)
5) NAME(last, first)
Listing STATUS