Jupiter Ads - Advertisement order form

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ADVERTISEMENT ORDER FORM

Please fill in the following form completely and arrange to send it at the earliest. After submitting this form, wait for our e-mail message. So that your advt. will appear on newspapers well in advance. On receipt of your advertisement , we will calculate the amount depending on size and nature of advertisement ordered, and will contact you by e-mail /phone. Western Union is a fastest money transaction company world wide.

Your Name

Address

City - State - PostCode

Country

Your Email Address

Category of advertisement: SELECT ONE)

Mention the editions you want to advertise (tik on the box)

ALL INDIA	ALL INDIA + OVERSEAS
ALL KERALA	ALL KERALA+OVERSEAS
KOTTAYAM	TRIVANDRUM
KOCHI	TRICHUR
KOLLAM	BAKGALORE
KANNUR	CHENNAI
KOZHIKODE	MUMBAI
MALAPPURAM	BLR+CHEN+MUM
PALAKKAD	BLR+CHEN
GULF	BBY+CHEN / BBY+CHEN

Date of Insertions

Day of Insertion

Number of Insertions

Advertisement type

Any special instructions?

Mode of payment

Advertisement Matter