~ EXCHANGE AMERICA, LTD. CO., FAX OR MAIL-IN ORDER FORM  ~

PO Box 4479, Durango, CO 81302

~ 1-800-982-3716, 24-Hour Messaging # ~ 970-375-7112, Direct ~ 305-513-5665, Fax ~  info@xusa.com, Email ~

SPECIAL, FOR NEW USERS!  Fax or mail us this completed form or email us your contact information to be eligible for our free services... To request advertiser contact information, to receive have/want information or to place low-cost ads! 

            Option 1 is our paid Online/Offline Advertising Program:
            All paid advertisers get free contact with users at incredibly low prices!  

            Option 2 is our optional "blended" Offline Data-Matching Service:
 Your paid ad makes you eligible for our Free-Until-Matched Program, subject to a Matching Fee.   


 Your Name_____________________________ Bus./Daytime #(___)_______________x.____ (Opt.): Evening#(___)________________

 Company Name (if applicable):_____________________________ Address:________________________________________________________

 Fax (___)_________________ Cell/Pager__________________ Email_____________________

 Would you be an Online or Offline user of our service? Online__ Offline__ Would you like to be contacted to learn more about us? Yes__ No__  Would you like to be on our free "broadcast" list to receive our haves & wants? Yes__ No__  Do you have immediate questions/comments?

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 FREE & LOW-COST PAID SERVICES...

Online Web Page(s) Advertising is priced for 6 months and Broadcast Advertising is priced for two months.  All paid advertising includes free user contact, upon request by email or thru our 800# Messaging!    

SERVICES:                                                                                                                                            PRICES:

REGISTRATION...                                                                                                         

    Offline Data-User Registration  (Fax above Contact Info. Free data entry,  thru  6/31/00)..                           $ 0   

    Online Data-User Registration (Go Online to http://xusa.com and register for free)                                        -0- 

WEB PAGE(S)' ADVERTISING - Prices are for 6 months, including an Email Contact Form.Your Page(s)
            each ad receives a broadcast announcement & your URL is released to Online directories...

            Custom Web Page Photo-Text Ad (*Prepped copy is programmed & hosted)                            95.00  ____

            Extra Page of  text & photo/graphic, .is programmed and hosted                                                 45.00  ____

            Web Site/Walkthru - Up to 6 linked photo/graphic or text pages in combination...                       295.00  ____

            7 or more Additional Page(s), each..                                                                                             35.00 ____

HOSTING SERVICES - Your existing HTML Page(s) is hosted for 6 months in an exclusive Front Page                                       section: Individual Web Page, $30; each additional, $15.  Six Pages, $95; each additional, $10.                    _____

Select one Web Page(s) Opportunities' classification..

Real Estate, Residential__ /Commercial__, Business /Investment__, Lender__, Vacation__,  Rentals__,                         Relocations & Exchanges__, Barter for Real Estate__, Brokers__, Related__                                                          Inc.

Additional Web Page Classifications, each...                                                                                        25.00 ____

FEATURE(S)' "BROADCAST" ADVERTISING to online and offline users by fax & email:

            Email/Fax Monthly Ads, per issue: 1-Line (85 spaces), $12; 2-Lines, $22; 3-Lines, $32.                          ____

            Special Email Broadcasts, Regional 1 have/want, $45; International, $75; more than 1, $95/125                ____

            Special Fax/Email Issues:

Regional broadcast, 1 have/want, $70; more than 1, $95                                                                         ____

            International broadcast, 1 have/want, $150; more than 1, $195                                                                ____

 TOTAL DUE (New Mexico residents, add 6.125% Tax):                                                                                 $   _____

Please enter credit card information here:  Type of credit card____________ Amount______ Name & address on card, if different from above___________________________________________________________________________Exp.____

 Call or fax in credit card information.  Or send a check or money order, payable to Exchange America, LLC - include ad copy - & mail to Exchange America, LC, PO Box 580, Aztec, NM 87410 or PO Box 4479, Durango, CO 81302. You may also email copy to info@xusa.com.  Call or email us, if you have questions.