Advertising Order Form

Please fill out the following form after you have viewed our advertising rates, discount plan and other relevant details


Contact person

Full address

Telephone (with country & area codes)

Fax (with country & area codes)


Option chosen (Banner or Panel?)

For how many months?

From which date to which date?

Will you supply the banner or panel? Yes/No

Do you have a home page to which your ad should be linked? Yes/No

If answer to above is 'yes', what is its URL?

If you don't have a home page, do you one free? Yes / No

Will you pay in Indian rupees or US dollars?

Total amount payable

(you may leave this blank as it will be detailed in our pro forma invoice)

Special instructions or query (if any)

Date (day/month/year)