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RESTAURANT DIRECTORY
SUBMISSION FORM
Instructions:
1. Enter your data in the boxes provided. If you have more than one directory, please submit separate forms.
2. Click the "Submit Directory Entry" button at the bottom.

Name of Restaurant:

Note: Display advertisers receive free directory listings in the publication and on the web listing.
Please click on one.

4x Display Advertising w/Free Directory and Web listing.
Directory Only ($135 per year) Web listing included.
Web Listing Only (Free)

Have a logo you want to appear? Please send as a separate e-mail attachment to

Street Address :

City or Area:
If Other, please specify location:

Zip Code:

Contact Name:

Contact Phone: Please use ( ) for Area Code

Contact Fax: Please use ( ) for Area Code

Contact E-Mail:
PLEASE fill in your E-Mail address, even if you think Boulder County Kids already has it.
Check if you do NOT want your e-mail address to appear in your directory.

Web Address (optional):

Days and Hours:

Ages:


•••• Program Description ••••

Please provide a brief description of your Menu and Kid-Friendly Specials. (limited 15-30 words please)

Start Date:

Boulder County Kids • P.O. Box 17114 • Boulder, CO 80308
Phone: (303) 939-8767 • E-Mail:
© 1995-2008 Boulder County Kids. A division of Martinhouse Publishing, Inc. All rights reserved.
Reproduction in whole or part without written permission prohibited.
Special thanks to Bear Creek Elementary School of Boulder for the drawings.
Website by Bolderwomen : http://www.bolderwomen.com