Information needed for online advertisement www.sadoctors.co.za

Please type in info into text boxes below, as applicable This completed document must be emailed back to us as indicated at the end of this document. Name of business/practice/establishment:

VAT Number (if applicable)

Type of business/practice/establishment:

Practice number (if applicable):

Qualifications (if applicable):

Physical address:

Postal address:

Phone number(s): +27 (0) +27 (0)

Fax number: +27 (0)

Cell number(s) (optional): +27 (0) +27 (0)

A/H phone number(s) (optional): +27 (0) +27 (0)

Contact Name(s): Email address:

Website address (if applicable):

Facebook address:

Twitter address:

YouTube address:

Skype address:

Instagram address:

Medical aid info (if applicable):

GPS co-ordinates (in not available, we will get them for you from Google Earth):

Description of the practice / business:

I am choosing to (delete whatever is applicable - advertising rates can be seen below) Take advantage of the 1st time advertiser's special offer for 6 months Advertise for a year and pay for a year upfront at standard rates Advertise for a year and pay monthly at standard rates Advertise for xxxx months and pay monthly / upfront at standard rates Images needed Please email images (photos, logos, etc) together with this form or we can come and take photos for you (photographic service in Cape Town area only and included in the rates).

ADVERTISING RATES: Compulsory:  Once off setup fee: R500 plus VAT.  Annual advertising fee: R200 plus VAT per month or R2 000 plus VAT per year (20% discount for annual upfront payment).  All directory advert views are charged in arrears at R0.25 plus VAT (25 cents plus VAT) per view. These directory advert views will be invoiced in arrears monthly, bi- monthly, quarterly, six monthly or annually, as per your choice).

1st Time Advertiser's Special Offer Are you unsure if this advertising medium will work for you? Then you are invited to take advantage of our 1st time advertiser's special offer and advertise for 6 months with no monthly fee (R1 200 plus VAT free value). Thereafter, you may discontinue or continue at standard rates. These 6 months should give you a massive return on your adspend and you will be able to use all of our value added online services. Once off setup fee: R500 plus VAT Monthly advertising fee: Nil All directory advert views are also charged in arrears at R0.50 plus VAT (50 cents plus VAT) per view and invoiced after the 6 months period has expired. Our software tracks these directory advert views very accurately.

Optional extras:  A hyperlinked logo on the home page of this portal: R330 plus VAT per month or R3 300 plus VAT per 12 months (20% discount for upfront annual payment).  A hyperlinked banner on the home page of this portal: R450 plus VAT per month or R4 500 plus VAT per 12 months (20% discount for upfront annual payment).

The following free value added services are available to our advertisers:

 Update your advert free of charge at any time by simply emailing us the details to be updated/changed/added;  Have a photo of yourself or your premises, equipment, etc. Simply email these to us;  Have articles re your area of expertise published on the site. Simply email these articles to us;  Have info re any events, meetings or general news published on the site. Simply email the details to us, including images if applicable.  Advertise vacancies in your business.

All advertisers receive monthly feedback as to the activity of their advertising on this portal, as in how many times their directory adverts have been viewed and how many times their logos have been clicked on.

A year is 12 months from date of order.

Please email this completed document to [email protected] Contact: Marius Boraine Tel: +27 (0)21 556 1141 Cell: +27 (0)82 897 9854 Fax: 086 671 5009