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Personnal information

Civility : Mr Mrs Miss
Name : *
First name :
Job Title : *
Email : *
Phone Direct : (international format)
Fax Direct : (international format)
Company information

Company : *
Address : *
County / Zip Code : *
City : *
Country : *

Other country (if not listed, select 'Other country' at the end of the Country list)
Company phone : * (international format)
Company fax : (international format)
Company email :
Company Web Site :
Please state the status of your company at this address :  *
 
I ORDER :

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I SEND MY BANNER :

Now you can upload and send us your banner now, by clicking on "SELECT FILE" button.

Please indicate the URL's destination (your website or a particular page on your website).

Accepted type of file : gif, jpg, png

File size limit : 120KB

The file name must not include spaces or accented characters



You choosed ""
Please upload your banner for whole site :
File size: 160px width, 160px OR 120px height
Banner file : *
Any mistake ? click here to re-upload banner
Destination URL : * (http:// ...)
 
Please upload your banner for specialised page :
File size: 400px width max (will be reduced for a print on a 2 columns specialised page)
Banner file : *
Any mistake ? click here to re-upload banner
Destination URL : * (http:// ...)
 

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