Salam Halal

www.salamhalal.lk

ISLAMIC INFORMATION PORTAL

SUBSCRIBER APPLICATION FORM

Section 1 � Primary Contact Details

Provide the details of the main contact person for this subscription.

First Name *

First name is required.

Last Name *

Last name is required.

Job Title

Email Address *

Valid email address is required.

Phone Number *

Section 2 � Business Details

Information about your registered business organization.

Registered Company Name *

Registered company name is required.

Trading Name (if different)

Business Website URL

Please enter a valid website URL starting with http:// or https://

Industry Category / Niche *

Please select an industry category.

Physical Street Address *

Physical street address is required.

City, Province, Postal Code *

City, Province, and Postal Code are required.

Branches

Add multiple branch locations if your business operates in more than one area (Optional).

Section 3 � Directory Portal Content

Describe your business and upload your official logo.

Business Description * 0 / 500 words

Maximum 500 words

Business description is required.

Upload Business Logo

Drag & drop your logo here, or browse file

PNG or JPG � Square image preferred

Section 4 � Standard Business Hours

Specify your weekly operating schedule.

Day	Opening Time	Closing Time	Closed
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Section 5 � Subscription Details

Specify your subscription duration and amount.

Annual Subscription Amount

From Date

To Date

Section 6 � Authorization & Submission Terms

Read and accept terms to complete your application.

By submitting this form, I certify that the business information provided is correct and authorize its publication on www.salamhalal.lk Islamic Information Web Portal. I understand that I am responsible for maintaining accurate content and image rights for any uploaded media.

Authorized Signature: *

Draw signature here

Date *

Signature date is required.

I confirm that the information provided above is correct and I agree to the submission terms. *

You must check the agreement box before submitting.

Cancel