LISTALL ADVERTISING 

Advert Application

This form must be FULLY completed, printed, signed and faxed to us please.

Your Name and Surname     
Name of your business    
Type of Business
or Description of item you wish to market		    
Your Office Telephone number     
Your Cellular phone number        
ID Number (no spaces)                  
Email Address                 
Website address                    
 Individuals - Only R299 per month 
 Businesses - Only R499 per month   		 
 I prefer to pay     
If any of our Marketer approached or emailed you, please enter their name here  
I agree to pay the first payment  on  

          

I /We hereby request you to link and integrate my website to many Individual websites.

Signed at on this day of (Month and year)

 

........................................................................(I understand that this agreement is for a minimum term of SIX MONTHS)               
Signature of OWNER                                  Version    
 

  
   Print this document before pressing the submit button below.
Then sign the printed pages and fax it to us at 0866 124 303

   


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For more information contact Louis Kearney on Tel: +27 (0)12 361 0576 or Cell 083 281 2709 - South Africa

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