Intereliant Network Solutions - Participants Info - Advertising Sponsorship - Website Advertising Form
 Go to HERSTMONCEUX.ORG home page  Intereliant Network Solutions 
 Participants Info - Advertising Sponsorship - Website Advertising Form
 
<
up
>
 Domain Names  
 Free Software  
 Linux  
 Tech Support  
 Web Design  
 Site Map   Email 

Website Advertising Form

Website Advertising Order Form

Note: All items with an asterisk * are required.

Please do not complete the form using capital letters

This order is processed on a secure server. We don't automatically debit your credit card when you send this request. Our operators check it for accuracy first. This avoids incorrect orders that require refunds.

* First Name Initial *Title
* Last Name
Job Title
Company Name
*Address
Address
Address
* City/Town
* County, State or Prov.
* Postal Code / Zip
Country
Office Phone
* Home Phone
Mobile Phone
Office Fax
* Email Address
Web Site

I would like to apply for the following website advertising package;

Jester Package - Name and contact telephone number - FREE

Squires Package - Name, contact telephone number, email address. Distance to Herstmonceux Castle. A sentence about what the business does (no more than 20 words) - £20.00

Knights Package - Name, contact telephone number, email address, website address. Photo, logo or map. Distance to Herstmonceux Castle. Information about what the business does (no more than 100 words) - £30.00

(Please email us a photo or logo to info@mgel.com)

For payment please provide either you credit card or debit card details:

Credit Card or Switch Number
Credit Card or Debit Card Type
Card Valid From Date (if paying by Switch)
Card Expires Date (all cards)
Card Issue Number (if paying by Switch)
Issuing Bank (all cards)
Amount I want deducted from my card
Cardholder's Name and Initials as they appear on the card
CVV2*:

*CVV2 is a 3-digit value at the end of your account number printed on the back of your credit card.

CVV2

On American Express cards, CVV2 number consists of 3-4 digits located on the front of the card.

Put me on your mailing list.

* How did you hear about the Festival? or some other way? Please specify.

Any comments or requests?