Advertising Order Request

Please complete and submit the form below to confirm your interest in advertising with VIVE Lifestyle Network ("VLN"). Upon submission, VLN will issue an invoice within 48 hours, payment of which will secure placement.

Please indicate your position with the business/company.

Please double-check for accuracy, as the confirmation email will be sent to this address.

Please provide the business billing address for invoicing purposes.

Please check type(s) of advert(s) desired.

Please advise should you have any specific requests and/or should you need to indicate the number of product placements above five (5).

I agree to VLN's Terms & Conditions.