| 1.
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Brand Name of product to be Advertised |
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| 2.
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Name and Address of Manufacturer/Distributor
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State
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| 3.
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Evidence of letter or power of attorney from manufacturer/distributor
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| 4.
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Medium/Media for which advertisement approval is sought
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From:
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To:(
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| i.
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| ii.
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| iii.
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| iv.
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| v.
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| vi.
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| 5.
Advetising materials submitted |
| (Indicate number of TV,Radio Or Press/Poster/Outdoor materials submitted in each case |
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a.
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TV: |
Script
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Story Board
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VHS approval copy
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b.
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RADIO: |
Script
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Recording on audio cassette tape |
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c.
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PRESS: |
Copy/Layout
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Colour Visual/Mini-ProofCopy
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d.
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OUTDOOR: |
Copy/Layout
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Colour Visual/Mini-ProofCopy
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e.
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POSTAL |
Copy/Layout
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Colour Visual/Mini-ProofCopy
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f.
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OTHERS |
Copy/Layout
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Colour Visual/Mini-ProofCopy
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6.
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Samples of Product Submitted |
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Number |
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7.
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8.
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Name and Address of ad agency/organisation seeking approval |
a.
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Org/Address |
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b. |
Name of Applicant |
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APCON Registration No
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Phone |
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