Virtual Broad Ripple Upgrade Form


Upgrade Package Selection

Tier 2 - $8 per month (12 month billing) - Adds bold listing, phone number, one page web page with website link, and hours.

Tier 3 - $11 per month (12 month billing) - Tier 2 plus photo of your location and a "See Inside" page with up to 10 images inside your location.

Tier 4 - Prices upon request - Tiers 2 & 3 plus additional web pages, restaurant menu, etc.


Billing Information
First Name *

Last Name *

Organization

Attention

Street Address *

City *

State *

Zip Code *

Telephone *

Email (Required to receive notification via email)

* required information

Payment Method

Alternate Credit Card information
$5 processing fee will be added.
Preferred method is "Pay directly with Square" option above
  Only fill this section in if you chose ALTERNATE CREDIT CARD METHOD ABOVE

Credit Card Number

Exp. date MM/YY

3-digit code from back of card
(4-digit code on front of AMEX cards)

Credit card billing Zip Code

Visa   | MasterCard   | Discover   | American Express


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Please click the CONTINUE button to view final invoice page.
Your upgrade will not be placed until you have approved the final invoice page.