Name of Representative:
Position in Organisation:
Name of Company Organisation:
Postal Address Details:
Physical Address Details:
Email Address:
Tel:
Fax:
Cell:
Web Site:
Please indicate Industry Sector:
Please provide products and/or services you offer within this Industry Sector:
Please include any other additional expertise/information or references here:
NOW WE NEED YOU TO INDICATE THE "LEVEL" OF PARTICIPATION BY'YES' IN THE APPROPRIATE BOXONE OF FOUR OPTIONS AVAILABLE:
AS A LISTED FDA CONTACT
We will 'LIST' your company, product or service info (basic) on our world-rated website - FREE!
OR
AS A FDA DETAILED CONTACT
We will boldly list your company and your service/products with a link to your own webpage listing
(if you have a website available)
PLEASE NOTE:
To be 'listed' as a FDA DETAILED CONTACT you will have to contribute (around US$ 170.00 - Exchange Rate 7-1) per annum (around US$ 17.00 - Exchange Rate 7-1)
OR
AS A FDA TRADING PARTNER
We will 'SHOWCASE' you, your company and your service/products, (if you have one available)
PLEASE NOTE:
To be 'showcased' as a FDA TRADING PARTNER you will have to contribute (around US$ 357.00 - Exchange Rate 7-1) per annum (around US$ 32.00 - Exchange Rate 7-1)
OR
AS A FDA SUPPORTER - PAGE SPONSOR
We will 'SHOWCASE' you, your company and your service/products, (if you have one available)
PLEASE NOTE:
To be 'showcased' as a FDA SUPPORTER - PAGE SPONSOR you will have to contribute (around US$ 3575.00 - Exchange Rate 7-1) per annum (around US$ 315.00 - Exchange Rate 7-1)
