Please submit the following form to purchase an ad in the Willy Wonka and the Chocolate Factory Program. Name(Required) First Last Email(Required) Student Name First Last 1/4 Page Ad Quantity Price: $25.00 Quantity 1/2 Page Ad Quantity Price: $50.00 Quantity Full Page Ad Quantity Price: $100.00 Quantity Total Credit Card(Required)Card Details Cardholder Name