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Advertising online submission form

Please provide the following contact information:

Name:
Are you a Member of an Australian State Podiatry Association or Podiatry New Zealand?: Yes No
If no, are you submitting this on behalf of a Member? Yes No
Name of Member:
Organisation:
Postal address:
Phone:
FAX:
E-mail:

Enter the text below. Payment must be made by credit card after this submission if you are not elegible for a free advertisement, so you should calculate the number of words in your advertisement either way. For help with this, click here. Please note there is a minimum of 30 words and a maximum of 250:

Note: The closing date is 25th of each month for advertising in the following month.

The site is only updated on the 1st of each month. It is your responsibility to re-submit this form if you wish to continue advertising each month.

Please note, if you do not forward a credit card payment form after submitting this advertisement it will not be processed - unless you are elegible for a free advertisement. You will receive confirmation once the payment has been received or your eligibilty confirmed.

 


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