Birth Market Advertiser Registration

This form registers you as an advertiser in Midwifery Today's Products and Services Directory. Once you have registered, you will be able to log in to our online system anytime you want to create or modify an ad.

Please click here for prices and additional information

If you have not yet paid for your ad, you can do so after submitting it. However, please note that your ad will not be activated until payment is received.

To pay by Visa or MasterCard you may do so conveniently in our online store or by calling 1-800-743-0974 (toll free in U.S./Canada). To pay by check/money order, send to:

Midwifery Today
PO Box 2672
Eugene, OR 97402

If you would like to contact us before submitting your ad, just send e-mail now to

birthmarket@midwiferytoday.com

The information you provide on this form will be held in the strictest confidence by Midwifery Today, Inc. In addition, this information will not appear in your ads without your explicit permission. When you create an ad, you will be able to specify that an entirely different address or phone number should appear in your ad; or that no address or phone number should appear in your ad.

  *  Fields marked with an asterisk are required.

 

Each time you log in to our online system, you will be asked to provide your e-mail address and a password. You should provide your actual e-mail address, since we will use it to communicate with you about your ads.

However, your password does not need to be the same as the password you use to access your e-mail. In fact, for security reasons, you should choose a different password for access to Midwifery Today's online system. You may use any combination of letters and numbers, but no spaces or punctuation should be used.

E-mail:*
Password:*

Please re-enter your password below. Then make a careful note of the e-mail address and password you have used here, since you will use them again the next time you log in.

Password:*
 

Please tell us how we can contact you.

Company Name:*
Contact Name:*
Address:*
City:*
State / Province:*
Country:*
ZIP / Postal Code:
Phone:*
Fax:
 

Just click the button below to submit your registration.