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I wish to subscribe to Film India Worldwide and enclose a Cheque/Demand Draft towards annual subscription of Rs. 400 OR US$ 25 OR Euro 16.50 including courier charges. Cheque/Demand Draft No: dated: drawn in favour of Uma da Cunha Name: Designation/Organisation: Address: City: Tel: Email: Mail to: Uma da Cunha, Editor and Publisher, Film India Worldwide, 10 Fairlawn, 128, M. Karve Road, Mumbai 400 020, India. Tel: (91 22) 2282 6699 e-mail: umadacunha2003@yahoo.com, umadacunha@gmail.com Fax: Country: Signature:

FIW Coupon.indd 1

9/6/2009 11:57:55 AM

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