CINXE.COM

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src="https://www.jotform.com/uploads/smprofiles/form_files/YourStory%20Red.6627801f141042.81152932.png" height="137px" width="680px" data-component="image" role="none" aria-hidden="true" tabindex="-1" /></div> </div> </li> <li class="form-line" data-type="control_text" id="id_14"> <div id="cid_14" class="form-input-wide" data-layout="full"> <div id="text_14" class="form-html" data-component="text" tabindex="-1"> <p>If you are interested in a paid partnership for Display Ads and would like to get in touch with our sales team, please fill in the following questions.</p> </div> </div> </li> <li class="form-line jf-required" data-type="control_textbox" id="id_4"><label class="form-label form-label-top form-label-auto" id="label_4" for="input_4" aria-hidden="false"> Organisation<span class="form-required">*</span> </label> <div id="cid_4" class="form-input-wide jf-required" data-layout="half"> <input type="text" id="input_4" name="q4_typeA" data-type="input-textbox" class="form-textbox 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sublabel_3_first" required="" value="" /><label class="form-sub-label" for="first_3" id="sublabel_3_first" style="min-height:13px">First Name</label></span><span class="form-sub-label-container" style="vertical-align:top" data-input-type="last"><input type="text" id="last_3" name="q3_fullName[last]" class="form-textbox validate[required]" data-defaultvalue="" autoComplete="section-input_3 family-name" size="15" data-component="last" aria-labelledby="label_3 sublabel_3_last" required="" value="" /><label class="form-sub-label" for="last_3" id="sublabel_3_last" style="min-height:13px">Last Name</label></span></div> </div> </li> <li class="form-line jf-required" data-type="control_textbox" id="id_6"><label class="form-label form-label-top form-label-auto" id="label_6" for="input_6" aria-hidden="false"> Designation<span class="form-required">*</span> </label> <div id="cid_6" class="form-input-wide jf-required" data-layout="half"> <input type="text" id="input_6" name="q6_designation" 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</li> <li class="form-line jf-required" data-type="control_phone" id="id_9" data-compound-hint=",##########"><label class="form-label form-label-top form-label-auto" id="label_9" for="input_9_area" aria-hidden="false"> Mobile Number<span class="form-required">*</span> </label> <div id="cid_9" class="form-input-wide jf-required" data-layout="half"> <div data-wrapper-react="true"><span class="form-sub-label-container" style="vertical-align:top" data-input-type="areaCode"><input type="tel" id="input_9_area" name="q9_mobileNumber[area]" class="form-textbox validate[required]" data-defaultvalue="" autoComplete="section-input_9 tel-area-code" data-component="areaCode" aria-labelledby="label_9 sublabel_9_area" required="" value="" /><span class="phone-separate" aria-hidden="true">聽-</span><label class="form-sub-label" for="input_9_area" id="sublabel_9_area" style="min-height:13px">Country Code</label></span><span class="form-sub-label-container" style="vertical-align:top" data-input-type="phone"><input type="tel" id="input_9_phone" name="q9_mobileNumber[phone]" class="form-textbox validate[required]" data-defaultvalue="" autoComplete="section-input_9 tel-local" placeholder="##########" data-component="phone" aria-labelledby="label_9 sublabel_9_phone" required="" value="" /><label class="form-sub-label" for="input_9_phone" id="sublabel_9_phone" style="min-height:13px">Phone Number</label></span></div> </div> </li> <li class="form-line jf-required" data-type="control_checkbox" id="id_10"><label class="form-label form-label-top form-label-auto" id="label_10" aria-hidden="false"> Form of Paid Partnership (Tick all that are suitable.)<span class="form-required">*</span> </label> <div id="cid_10" class="form-input-wide jf-required" data-layout="full"> <div class="form-single-column" role="group" aria-labelledby="label_10" data-component="checkbox"><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_10" type="checkbox" class="form-checkbox validate[required]" id="input_10_0" name="q10_formOf[]" required="" value="Digital Banner Advertisement" /><label id="label_input_10_0" for="input_10_0">Digital Banner Advertisement</label></span><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_10" type="checkbox" class="form-checkbox validate[required]" id="input_10_1" name="q10_formOf[]" required="" value="Written Branded Content" /><label id="label_input_10_1" for="input_10_1">Written Branded Content</label></span><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_10" type="checkbox" class="form-checkbox validate[required]" id="input_10_2" name="q10_formOf[]" required="" value="Video Content" /><label id="label_input_10_2" for="input_10_2">Video Content</label></span><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_10" type="checkbox" class="form-checkbox validate[required]" id="input_10_3" name="q10_formOf[]" required="" value="Events" /><label id="label_input_10_3" for="input_10_3">Events</label></span></div> </div> </li> <li class="form-line jf-required" data-type="control_textarea" id="id_19"><label class="form-label form-label-top form-label-auto" id="label_19" for="input_19" aria-hidden="false"> Please describe your requirement in brief (Max 200 Words)<span class="form-required">*</span> </label> <div id="cid_19" class="form-input-wide jf-required" data-layout="full"> <div class="form-textarea-limit"><span><textarea id="input_19" class="form-textarea validate[required]" name="q19_pleaseDescribe" style="width:648px;height:163px" data-component="textarea" required="" aria-labelledby="label_19"></textarea> <div class="form-textarea-limit-indicator"><span data-limit="200" type="Words" data-minimum="-1" data-typeminimum="Words" id="input_19-limit">0/200</span></div> </span></div> </div> </li> <li class="form-line jf-required" data-type="control_radio" id="id_11"><label class="form-label form-label-top form-label-auto" id="label_11" aria-hidden="false"> Your Budget (estimate)<span class="form-required">*</span> </label> <div id="cid_11" class="form-input-wide jf-required" data-layout="full"> <div class="form-single-column" role="group" aria-labelledby="label_11" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_11" type="radio" class="form-radio validate[required]" id="input_11_0" name="q11_yourBudget" required="" value="1.5 - 5 Lakh" /><label id="label_input_11_0" for="input_11_0">1.5 - 5 Lakh</label></span><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_11" type="radio" class="form-radio validate[required]" id="input_11_1" name="q11_yourBudget" required="" value="5 - 10 Lakh" /><label id="label_input_11_1" for="input_11_1">5 - 10 Lakh</label></span><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_11" type="radio" class="form-radio validate[required]" id="input_11_2" name="q11_yourBudget" required="" value="Above 10 Lakh" /><label id="label_input_11_2" for="input_11_2">Above 10 Lakh</label></span></div> </div> </li> <li class="form-line jf-required" data-type="control_radio" id="id_12"><label class="form-label form-label-top form-label-auto" id="label_12" aria-hidden="false"> By signing up for this you agree to the Terms of Service (https://yourstory.com/terms-and-conditions) and Privacy Policy (https://yourstory.com/privacy) of the platform<span class="form-required">*</span> </label> <div id="cid_12" class="form-input-wide jf-required" data-layout="full"> <div class="form-single-column" role="group" aria-labelledby="label_12" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_12" type="radio" class="form-radio validate[required]" id="input_12_0" name="q12_bySigning" required="" value="I accept" /><label id="label_input_12_0" for="input_12_0">I accept</label></span><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_12" type="radio" class="form-radio validate[required]" id="input_12_1" name="q12_bySigning" required="" value="I don't accept" /><label id="label_input_12_1" for="input_12_1">I don't accept</label></span></div> </div> </li> <li class="form-line always-hidden" data-type="control_textbox" id="id_16"><label class="form-label form-label-top form-label-auto" id="label_16" for="input_16" aria-hidden="false"> utm_source </label> <div id="cid_16" class="form-input-wide always-hidden" data-layout="half"> <input type="text" id="input_16" name="q16_utm_source" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_16" value="" /> </div> </li> <li class="form-line always-hidden" data-type="control_textbox" id="id_17"><label class="form-label form-label-top form-label-auto" id="label_17" for="input_17" aria-hidden="false"> utm_medium </label> <div id="cid_17" class="form-input-wide always-hidden" data-layout="half"> <input type="text" id="input_17" name="q17_utm_medium" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_17" value="" /> </div> </li> <li class="form-line always-hidden" data-type="control_textbox" id="id_18"><label class="form-label form-label-top form-label-auto" id="label_18" for="input_18" aria-hidden="false"> utm_campaign </label> <div id="cid_18" class="form-input-wide always-hidden" data-layout="half"> <input type="text" id="input_18" name="q18_utm_campaign" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_18" value="" /> </div> </li> <li class="form-line always-hidden" data-type="control_textbox" id="id_13"><label class="form-label form-label-top form-label-auto" id="label_13" for="input_13" aria-hidden="false"> Avenue </label> <div id="cid_13" class="form-input-wide always-hidden" data-layout="half"> <input type="text" id="input_13" name="q13_avenue" data-type="input-textbox" class="form-textbox" data-defaultvalue="Display Ads" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_13" value="Display Ads" /> </div> </li> <li class="form-line" data-type="control_button" id="id_2"> <div id="cid_2" class="form-input-wide" data-layout="full"> <div data-align="auto" class="form-buttons-wrapper form-buttons-auto jsTest-button-wrapperField"><button id="input_2" type="submit" class="form-submit-button form-submit-button-reports-400 submit-button jf-form-buttons jsTest-submitField legacy-submit" data-component="button" data-content="">Submit</button></div> </div> </li> <li style="display:none">Should be Empty: <input type="text" name="website" value="" type="hidden" /></li> </ul> </div> <script> JotForm.showJotFormPowered = "0"; </script> <script> JotForm.poweredByText = "Powered by Jotform"; </script><input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="241131402067038" /> <script type="text/javascript"> var all_spc = document.querySelectorAll("form[id='241131402067038'] .si" + "mple" + "_spc"); for (var i = 0; i < all_spc.length; i++) { all_spc[i].value = "241131402067038-241131402067038"; } </script> </form></body> </html><script type="text/javascript">JotForm.isNewSACL=true;</script>