Computer Jagat

N.B.: Cheques/Drafts are to be drawn in favour of “COMUTER JAGAT”.

* : mandatory fields

Subscription Type :*	Group Individual
Subscription Option:*	6 months 1 year
Subscription start date: *	/
Name : *
Mailing Address:*
	State:	Pin:
	City:	Other:

Occupation:*
Designation: *
Age(yrs):*
Phone/Mobile No:*	Please enter area code for Land line no.
Email:
Number of copies (per month):*
Delivery Address:*
same as mailing address	State:	Pin:
	City:	Other:
Pay by:*	Cheque Draft

Enclosed herewith is a Cheque/Draft No:* /

Dated:* - - (dd-mm-yyyy) / for Rs* : /

Drawn on :*