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Radio FM 88 Tourist Network On-Line Commercial and Payment Form

This transaction is for Buying air time on Radio FM 88 Tourist Network
Payment to go to Radio FM 88 Springwood
Registered in the State of Queensland: Country of Australia

Name of Advertiser ( company / organisation )
Name of person authorised to place ad
Contact phone number
What day do you want ad to Start
What day do you want ad to Finish
How many times do you want ad repeated
A 30 second commercial is 60 words A 60 second commercial is 120 words
Payment in Trade Terms Payment By Card Type Card Expiry Date
Name of Bank that Issued Card
Country Where Card Issued
Price per ad ( see Advertising Rates )
Number of times ad to be repeated
Total Invoice Amount
Card Holder's Name
Card Number
Card should contain 16 numbers ( example only )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Office:
Confirmation by Radio FM 88 Springwood

Name :

Email :

Signature: