This form is ONLY for the placing of a Political Advertisement for LEGALLY QUALIFIED CANDIDATES running in Peabody or Lynnfield on the bulletin board provided by Comcast. The rate of $5.00 per day must be paid in advance. Please complete the form and BRING or MAIL it to:

Political Advertisement
Community Bulletin Board

Comcast Peabody
167 Washington St.
Peabody, MA 01960
Phone: (978) 531-5320

1. Please use this form, flyer or typewritten note in its place;
2. Messages must be received at least one week prior to desired start date;
3. Messages may be displayed up to 60 days then must be renewed;
4. Keep complete words on the same line; do not hyphenate words at the end of a line;
5. Include the basics and provide a contact phone number in the message, if applicable;
6. Messages may not be longer than one page.

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Submitted by:_________________________ Campaign Staff Title____________________

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Candidate’s Name_________________________ For the Office of____________________

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Political Party____________________ Contact Phone Number to Campaign_______________

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Candidate’s Address_________________________ Town Zip Code__________

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Candidate’s Signature______________________________ Date__________

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Comcast Employee____________________ Position____________________ Date__________