November 20, 2009

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Reader Poll

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Delivery Start / Stop Form

If you are going on vacation don't forget to stop your paper. To have paper your paper start or stopped please fill out form below. Questions? Contact us: Call 620-342-4800 email: circulation@emporiagazette.com

Customer name:

Delivery address:

city:

Zip code:

Do you want to start or Stop your paper

Date to start paper:

Date to stop paper:

What do you want us to do with your papers while you are gone? Choose an option below.

Donate paper credit to Newspapers in Education: Yes / No

(Credit accrued each day you're away is automatically donated to our fund to provide area classrooms with newspaper for educational use free of charge. For each day you are away, two newspapers will be donated.)

Save papers with a Vacation Pack: Yes / No

(Papers will be saved by your carrier while you are gone and will be delivered on designated start date.)

Credit my account: Yes / No

(Each day you are away, your expiration date will be extended by one day.)

Form completed by:

Your Name:

Date:

Your telephone number:

Your email address:

Your message:

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