Local Government Business Directory


Booking Form for the 'on-line edition 2009/10'

Includes: A full feature entry on the Local Government Web Site www.localgovernment.biz
plus an identical entry at www.LGnet.com.au

* denotes an essential field
Section 1: Your Details.
Your Contact Details -
(not for publication)
First name:
*
Last name:
*
Company name:
*
Job Title:
Email address:
Office phone:
*
Mobile Ph:
FAX :

BOOKING OPTIONS - (not for publication)
Select your Booking Option
New Booking
Renew entry - No changes
Renew entry - with changes
Develop and publish a new entry:
$.00
Host & maintain entry to 1st July 2010:
$.00
Subtotal 1:
$.00
Pro rata discount for Hosting and Maintenance (New Bookings only):
$.00
Subtotal 2 ():
$.00
+ GST:
$.00
TOTAL incl GST ():
$.00
Note: All prices listed are in Australian dollars.
All entries are maintained through to 1st July 2010 including unlimited changes

You have selected:
Booking Type:
Total Amount $.00 + $.00 GST
Please select a Booking Option


Section 2: Your Company and Product Details.

Company Name:
Company Motto / Short Descriptor (45 characters max):

Street Address:
Street No. & Name:
Suburb: State: Postcode:
Postal Address (optional):


Contact Name (preferred contact person for Local Government Enquiries:

Tel: Area Code: ( ) Phone Number:
Fax: Area Code: ( ) Fax Number:
Mobile:
Email:
Web:

What does your company do? (max 100 characters):

Your Company Profile / CV
Include now, or email through later.
(no maximum length although we suggest around 100-300 words):

Local Government Referees / References / Previous Projects:
If you have supplied to Local Government previously, include a list of Local Governments.
.......even better, referees that are willing to receive calls to comment on your company or products.

Business Entry Administration
Do you have any comments or instructions concerning your Business Entry
(use this box to list any special instructions to us......
This will not be displayed on your final entry.)
Section 3: Complete your booking.

Your Purchase Order (optional):


For Advertising Agencies only, please enter your Advertising Agency Name below.


On completion of the entry, an invoice will be posted to cover the development and management of your entry for the year.

Credit Card facility available late 2009.

To complete your booking: