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RADIO VERITAS ADVERTISING FORM
Business Details
Company Name
*
Contact Person
*
Designation
*
Phone Number
*
Email Address
*
Website (If applicable)
Social Media Profile Link
Physical Address
*
Select Your Advertising Package: (Please tick the appropriate box)
*
Select Your Advertising Package: (Please tick the appropriate box)
1
Bronze Package - R 500,00
2
Silver Package - R 3 500,00
3
Gold Package - R 6 200,00
4
Platinum Package - R 12 500,00
Business Description:
*
Advertising Goals:
*
Payment Information
*
Payment Method:
Payment Information
A
EFT
B
Credit Card
C
Other
Banking Details:
Account Name: Radio Veritas Bank: Nedbank Branch: Cresta Branch Code: 192405 Account Number: 1924 319 233 Account Type: Cheque / Current Reference: Your mobile number and name
Agreement and Signature: By signing below, I confirm that I have read and understood the terms and conditions of the selected advertising package.
Signature
*
*
Submit
