Hi Berni, welcome to the forums.
I have to echo Lyn's point about following up on direct mail, if you don't then you might as well not send the mail out in the first place!
As far as advertising goes, what kind of response have you got? I haven't advertised anywhere yet as I don't think it is something that works for our industry, going on the respose other VA's have got.
Have you tried SEO, Google Adwords, Blogging, online networking and all of the web based type things you can do? If someone knows what a virtual assistant is they will be looking for them online. If someone is actively seeking a virtual partner they will not, imo, be looking in the local paper
I would also look at operating hours. I don't know what hours you work but I know being available during office hours has worked in my favour. Obviousy a lot of VA's have children at home and are restricted to turning things around overnight, but if you can be available during the day do be.
Try and get some PR done. If you don't feel confident doing it yourself then pay someone to do it for you.
Spend time attending networking events and exhibitions, you never know who you wil meet.
The slightly obscure one is to make sure you refer others. If you constantly refer people you know to your clients/associates businesses then they will start to refer you to theirs.
How long have you been going? If you are new then just be aware that things can be slow to start with. If you have been going for a while then maybe you have become a bit complacent? Maybe you need to shuffle your website around or look at offering different services?
Sorry for babbling, you have probably done most of these things and I don't want to be telling you the obvious
Good luck!
Sara
Edit:
MCDST info