Gecko [ v3.cesa.co.za ]

Name	Size	Permission	Date
SpryAssets	[ DIR ]	drwxr-sr-x	2012-10-19 10:26
images	[ DIR ]	drwxr-sr-x	2013-12-13 14:32
Booking_Form_Member.html	9.59 KB	-rw-r--r--	2013-12-16 10:28
Booking_Form_Non_Member.html	9.6 KB	-rw-r--r--	2013-12-16 10:28
Booking_Form_Thanks.html	1.67 KB	-rw-r--r--	2013-12-16 10:28
Email_Member.html	3.57 KB	-rw-r--r--	2014-01-31 10:07
Email_Non_Member.html	3.44 KB	-rw-r--r--	2014-01-31 10:07
Live_Member.html	7.21 KB	-rw-r--r--	2014-01-31 10:07
Live_Non_Member.html	6.96 KB	-rw-r--r--	2014-01-31 10:07

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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
<title>CESA Non Member Booking Form</title>
<style type="text/css">

</style>
<script src="SpryAssets/SpryValidationTextField.js" type="text/javascript"></script>
<script src="SpryAssets/SpryValidationSelect.js" type="text/javascript"></script>
<script src="SpryAssets/SpryValidationTextarea.js" type="text/javascript"></script>
<link href="SpryAssets/SpryValidationTextField.css" rel="stylesheet" type="text/css" />
<link href="SpryAssets/SpryValidationSelect.css" rel="stylesheet" type="text/css" />
<link href="SpryAssets/SpryValidationTextarea.css" rel="stylesheet" type="text/css" />
</head>

<table width="600" border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td colspan="3"><img src="http://www.cesa.co.za/Directory2014/images/email_header_n.png" width="650" height="314" alt="CESA" /></td>
  </tr>
  <tr>
    <td width="24">&nbsp;</td>
    <td width="602"><h1>ADVERTISING BOOKING FORM:</h1></td>
    <td width="24">&nbsp;</td>
  </tr>
  <tr>
    <td valign="top">&nbsp;</td>
    <td valign="top"><table width="600" border="0" align="left" cellpadding="5" cellspacing="0">
  <tr>
    <td width="141" align="right">Company Name:</td>
    <td width="414">
      <span id="sprytextfield1">
        <label for="Name of Firm"></label>
        <input name="Name of Firm" type="text" id="Name of Firm" size="55" />
        <span class="textfieldRequiredMsg">Required.</span></span>
    </td>
    <td width="15">&nbsp;</td>
  </tr>
  <tr>
    <td align="right">Contact Person:</td>
    <td> <span id="sprytextfield2">
        <label for="Contact Person"></label>
        <span class="textfieldRequiredMsg">This is required.</span><span id="sprytextfield12">
        <label for="Contact Person2"></label>
        <input name="Contact Person" type="text" id="Contact Person2" size="55" />
        <span class="textfieldRequiredMsg">Required.</span></span></span></td>
    <td>&nbsp;</td>
  </tr>
    <tr>
    <td align="right">Email Address:</td>
    <td><span id="sprytextfield6">
    <label for="Email Address3"></label>
    <input name="Email Address" type="text" id="Email Address3" size="55" />
    <span class="textfieldRequiredMsg">Required.</span><span class="textfieldInvalidFormatMsg">Invalid format.</span></span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">Designation:</td>
    <td> <span id="sprytextfield3">
        <label for="Designation"></label>
        <span class="textfieldRequiredMsg">This is required.</span><span id="sprytextfield13">
        <label for="Designation2"></label>
        <input name="Designation" type="text" id="Designation2" size="55" />
</span></span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">Order No:</td>
    <td> <span id="sprytextfield4">
        <label for="Order No"></label>
        <span class="textfieldRequiredMsg">This is required.</span><span id="sprytextfield14">
        <label for="Order No3"></label>
        <input name="Order No" type="text" id="Order No3" size="55" />
</span></span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">VAT Registration No:</td>
    <td> <span id="sprytextfield5">
        <label for="VAT Registration No"></label>
        <span class="textfieldRequiredMsg">This is required.</span><span id="sprytextfield15">
        <label for="VAT Registration No2"></label>
        <input name="VAT Registration No" type="text" id="VAT Registration No2" size="55" />
</span></span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">Physical Address:</td>
    <td><span id="sprytextarea1">
      <label for="Physical Address6"></label>
      <textarea name="Physical Address" id="Physical Address6" cols="40" rows="5"></textarea>
</span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">Postal Address:</td>
    <td><span id="sprytextarea2">
      <label for="Postal Address4"></label>
      <textarea name="Postal Address" id="Postal Address4" cols="40" rows="5"></textarea>
</span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">Telephone Number:</td>
    <td><span id="sprytextfield7">
      <label for="Telephone Number3"></label>
      <input name="Telephone Number" type="text" id="Telephone Number3" size="55" />
</span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">Fax Number:</td>
    <td><span id="sprytextfield8">
      <label for="Fax Number3"></label>
      <input name="Fax Number" type="text" id="Fax Number3" size="55" />
</span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">Cell Number:</td>
    <td><span id="sprytextfield9">
      <label for="Cell Number3"></label>
      <input name="Cell Number" type="text" id="Cell Number3" size="55" />
</span></td>
    <td>&nbsp;</td>
  </tr>
   <tr>
    <td align="right" valign="top">Type of Advert:</td>
    <td valign="top"><span id="spryselect1">
      <label for="Advert Type"></label>
      <select name="Advert Type" size="1" id="Advert Type">
        <option selected="selected">Please Select a Advert Type</option>
        <option value="Quarter Page - R9 500.00">Quarter Page - R9 500.00</option>
        <option value="Half Page - R12 000.00">Half Page - R12 000.00</option>
        <option value="Full Page - R16 000.00">Full Page - R16 000.00</option>
        <option value="Page 1 (Full page) - R25 000.00">Page 1 (Full page) - R25 000.00</option>
        <option value="Page 2 (Full page) - R25 000.00">Page 2 (Full page) - R25 000.00</option>
    	 <option value="Inside Cover (Front and Back) - R30 000.00">Inside Cover (Front and Back) - R30 000.00</option>
        <option value="Back Cover (Outside) - R37 000.00">Back Cover (Outside) - R37 000.00</option>
        
      </select>
      <span class="selectRequiredMsg">Please select an item.</span></span></td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td align="right">&nbsp;</td>
    <td colspan="2"><label for="Submit"></label>
      <input type="submit" name="Submit" id="Submit" value="Submit" /></td>
    </tr>
</table>
</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td valign="top">&nbsp;</td>
    <td valign="top"><p><br />
      All prices are exclusive of agency commission and VAT. A detailed invoice will be issued (VAT Reg no. 4170109013)
      upon receipt of this booking form.<br /><br />
      Payments to CESA trading as SAACE by cheque or direct transfer to:
  <br />
  <strong>Bank:</strong> Nedbank <br />
  <strong>Branch:</strong>Ferndale <br />
  <strong>Account No.</strong>: 1922 019 801<br />
  <strong>Branch Code</strong>: 1922 05<br />
  <strong>Reference:</strong> DIREC2014_your company name</p>
      <p>&nbsp;</p></td>
    <td>&nbsp;</td>
  </tr>
  <tr valign="top">
    <td colspan="3"><p><img src="http://www.cesa.co.za/Directory2014/images/email_footer_n.png" width="650" height="229" alt="Footer" /></p>
      <p>&nbsp;</p></td>
  </tr>
</table></form>

</body>
</html>