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Order A Sample

We would be delighted to send you CD/DVD by a way of sample. Please complete this form so that we can send you the correct sample.

Required *

Personal Information

First Name *

Last Name *

Company Name

Address 1 *

Address 2

City *

State *

Zip *

Telephone *

Email *

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CD/DVD Information

I would like a sample of *

CD/DVD
Mini CD
Oval visiting card CD
Rectangular visiting card CD
Shipping and freight extra for outside Mumbai

I would like the sample CD/DVD to carry *

My image is attached

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Terms & Conditons *

I agree to pay Rs.300/- towards shipping and printing my own image on a CD/DVD sample. OR Rs.30/- towards shipping and printing Gaiakas image on a CD/DVD sample.

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Payment Detail

Please remit your cheque drawn in favour of Gaiaka Media Works Pvt. Ltd. Act. No. 0026 2011000311, Bank of India, IFSC code BK ID 0000026.

We shall send you the sample once your cheque clears. Thank you.