Join Gharda Chemicals Limited's List of Valuable Suppliers

<body bgColor="#000000" link="#00FFFF" text="#FFFFFF" leftmargin="5" topmargin="0"> <div align="center"><center><table border="0" cellPadding="5" cellSpacing="0" width="95%"> <TBODY> <tr> <td align="middle" colSpan="3"><p align="center"><font face="VERDANA,ARIAL" size="5"><b>Suppliers</b></font></td> </tr> <tr> <td colSpan="3"><font face="VERDANA,ARIAL" size="2"><b>If you are a manufacturer or dealer for the raw materials and intermediates required by agrochemicals / pesticides industries, please fill out the form below:</b></font></td> </tr> <tr> <td><form METHOD="POST" ACTION="http://www.gharda.com/cgi-gharda/formmail.cgi" name="guestbook"> <input type="hidden" name="recipient" value="gharda@gharda.com"><input type="hidden" name="subject" value="Suppliers Form"><input type="hidden" name="return_link_url" value="http://www.gharda.com/"><input type="hidden" name="return_link_title" value="Back to Main Page"><input type="hidden" name="redirect" value="http://www.gharda.com/thanksuppliers.html"><input type="hidden" name="env_report" value="REMOTE_HOST,REMOTE_ADDR,HTTP_USER_AGENT"> </form> </td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Company Name : </b></font></td> <td colSpan="2"><input name="s_cname" size="45"></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Address : </b></font></td> <td colSpan="2"><input name="s_add1" size="45"></td> </tr> <tr> <td></td> <td colSpan="2"><input name="s_add2" size="45"></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Pincode / Zipcode : </b></font></td> <td colSpan="2"><input name="s_zipc" size="45"></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>State : </b></font></td> <td colSpan="2"><input name="s_state" size="45"></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Country : </b></font></td> <td colSpan="2"><input name="s_cntry" size="45"></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Telephone : </b></font></td> <td colSpan="2"><input name="s_telp" size="45"></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Fax : </b></font></td> <td colSpan="2"><input name="s_fax" size="45"></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Email : </b></font></td> <td colSpan="2"><input name="s_mail" size="45"></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>URL : </b></font></td> <td colSpan="2"><input name="s_url" size="45"></td> </tr> <tr> <td rowSpan="2"><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Do you have a representative / dealer in India?</b></font></td> <td colSpan="2"><input name="s_dind" type="radio" value="Y"><font face="VERDANA,ARIAL" size="2"><b>Yes</b></font></td> </tr> <tr> <td colSpan="2"><input CHECKED name="s_dind" type="radio" value="N"><font face="VERDANA,ARIAL" size="2"><b>No</b></font></td> </tr> <tr> <td><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>If yes, please provide contact details : </b></font></td> <td colSpan="2"><textarea cols="45" name="s_dealcont" rows="7"></textarea></td> </tr> <tr> <td colSpan="3"><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Products you can offer to Gharda : </b></font></td> </tr> <tr> <td align="right"><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>1. </b></font></td> <td colSpan="2"><input name="s_prod1" size="45"></td> </tr> <tr> <td align="right"><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>2. </b></font></td> <td colSpan="2"><input name="s_prod2" size="45"></td> </tr> <tr> <td align="right"><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>3. </b></font></td> <td colSpan="2"><input name="s_prod3" size="45"></td> </tr> <tr> <td align="right"><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>4. </b></font></td> <td colSpan="2"><input name="s_prod4" size="45"></td> </tr> <tr> <td align="right"><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>5. </b></font></td> <td colSpan="2"><input name="s_prod5" size="45"></td> </tr> <tr> <td rowSpan="4" vAlign="top"><font face="VERDANA,ARIAL" size="2" color="#FFAB57"><b>Are you the manufacturer / dealer of the above products? </b></font></td> <td colSpan="2"><input name="s_mfdl" type="radio" value="manf"><font face="VERDANA,ARIAL" size="2"><b>Manufacturer</b></font></td> </tr> <tr> <td colSpan="2"><input name="s_mfdl" type="radio" value="deal"><font face="VERDANA,ARIAL" size="2"><b>Dealer</b></font></td> </tr> <tr> <td colSpan="2"><input name="s_mfdl" type="radio" value="othr"><font face="VERDANA,ARIAL" size="2"><b>Other - Please specify :</b></font></td> </tr> <tr> <td colSpan="2"><input name="s_othrsp" size="45"></td> </tr> <tr> <td></td> <td><input type="submit" value="Register"></td> <td><input type="reset" value="Clear Entries"></td> </tr> </TBODY> </table> </center></div> </body>