Harvest Drive Test Form Tweet Harvest Drive Platinum Level Test Platinum Level Ad SponsorThe information in this Ad Listing Details section will be published in the Harvest Drive E-Directory in early November. If you are purchasing a Family/Happy Ad, please complete the Family Name and Description/Message fields ONLY. Type of Ad*Business AdFamily/Happy AdBusiness or Family NameIf placing a Business Ad, describe your company or services. If placing a Family/Happy Ad, list your message. The Description/Message is limited to 100 words or less.Description or MessageAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone*FacebookTwitterInstagramWebsiteE-MailCategoryWhat category best describes your advertisement? Select "Family/Happy Ad" for non-business ads that express well wishes to PCHS or a student. Can't find an existing category that suits your business? No problem, simply select *custom category at the end of the drop down list and enter your category.Choose Category:*AccountingAdvertisingAsphaltAudio Service/SuppliesCustom Category:If none of the above apply, what should the category be?Student CreditIs there a PCHS student(s) or family that should receive credit for selling this advertisement?Student/Family Credit?* Yes, student name(s) listed below No, apply credit to a PCHS family with financial need NOTE: In cases of families with two or more students at PCHS, please list only one of the student's names. Credit will be divided equally among siblings.Student 1 First Last PCHS ID # (If known)Additional Student CreditYou may add up to three additional students or families. Credit will be divided proportionally.Student 2 First Last PCHS ID # (If known)Student 3 First Last PCHS ID # (If known)Student 4 First Last PCHS ID # (If known)Purchase OptionsPurchaser's Name First Last Purchaser's Email Choose Purchase Option: Paypal/Credit Card Check mailed to PCHS Check hand-delivered to PCHS Check given to student to turn in Platinum Level Ad Sponsor* Price: $500.00 Quantity: IMPORTANT - PLEASE READ THE FOLLOWING INSTRUCTIONS*Make check payable to PCHS *Write "Harvest Drive" in the memo section of the check *Include a printed confirmation of your online ad submission (you will receive via email) *Mail to: Providence Catholic Attn: Harvest Drive 1800 W Lincoln Hwy New Lenox, IL 60451 *Select "Yes" below once you have completed reading these instructionsDid you read the instructions?* Yes Thank you!NOTE: Upon selecting the Submit Ad button below, you will be redirected to the safe and secure PayPal website. You DO NOT need a PayPal account to make this payment; you may pay with any major credit card.CAPTCHA