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Advertise - Application Form

Contact Person
_____________________________________________________

 Name : Name
 Cell : cell
 Email : email


Company Details
_____________________________________________________

Company Name:  
Landline:
 
Cell Phone:
 
Fax:  
E mail:
 
     
Primary Product / Service  
Description  
Image  


Package
_____________________________________________________

Basic Listing

 R50pm
Link / 1 page Site

 R100pm
Custom

 Request a Quote
   
 

Additional Products / Services
 R10/pm for each additional service / product selected _____________________________________________________

Current Monthly Total

Catering limo jewellery
hall hair makeup
 

 

Billing Cycle _____________________________________________________

Monthly
 Yearly


Supporting Documents

 Contract

Payment Form  Copy of ID Terms and Conditions

 
 







 

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