DRISTIKON-SANGBAD
Advertising Request Form
Request Date
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Day
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Month
Year
Date
Ad Details
What is the purpose of the ad?
Do you want to avail our image ads in social media?
Yes
No
Duration of the Ad
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 months
Other
Company Details
Organization/Company Name
Organization/Company Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Person Name
First Name
Last Name
Contact Company Phone Number
Please enter a valid phone number.
Contact Company/Person Email
example@example.com
Description of your organization/company
Website URL
Please upload your logo here
Browse Files
Drag and drop files here
Choose a file
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of
Extra File (Custom)
Browse Files
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of
Payment Method
Cash
Bkash
Nagad
Other
How did you hear about us?
Facebook
Twitter
Instagram
YouTube
Google Search
Newspaper
Magazine
News Reporter
Other
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Approver Section
Approver's Name
First Name
Last Name
Approver's Comments
Approver's Signature
Date Signed
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Month
-
Day
Year
Date
Submit
Submit
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