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MEDIA BUYER REGISTRATION FORM
Registering As
SME / Local Business
Startup
Corporate / Enterprise
PSU / Government Body
Organization / Company Name
Business Category / Industry
-- Select Category --
FMCG
Retail (Offline / Modern Trade)
E-commerce / D2C
Real Estate
Education (Schools / EdTech / Universities)
BFSI (Banking, Financial Services & Insurance)
Healthcare (Hospitals / Pharma / Diagnostics)
Hospitality (Hotels / Resorts / Travel)
Tourism & Aviation
Automobile (2W / 4W / EV / Dealerships)
Media & Entertainment (Production Houses / OTT / Events)
IT / SaaS / Technology
Telecom
Government / PSU
Infrastructure & Construction
Manufacturing / Industrial
Startups / D2C Brands
Fashion & Lifestyle
Beauty & Personal Care
Food & Beverage (Restaurants / QSR / Cloud Kitchen)
Logistics & Supply Chain
NGO / Non-Profit
Political / Election Campaign
Jewelry & Luxury
Gaming / Esports
Agriculture / AgriTech
Energy / Power / Renewable
Legal / Consultancy Services
Others
Year of Establishment
Company Website
PAN
GST Number
Company Logo
State
-- Select State --
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Delhi NCR
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnatka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Odisha
Punjab
Rajasthan
Tamil Nadu
Telengana
Uttar Pradesh
West Bengal
City
Select a City
Contact Person Name
Designation
-- Select --
Owner
Founder
Marketing Head
Brand Manager
Media Manager
Procurement
Other
Email
Mobile
Address
Directly responsible for media buying?
-- Select --
Yes
No (I influence/recommend)
If No, Decision Maker Name & Designation
Media Types Interested In
Outdoor / OOH
Transit Media
Digital Screens / DOOH
Television
Radio / FM
Print
Cinema Advertising
Digital / Online Media
Influencer Marketing
Other
Preferred Media Geography
Pan India
Metro Cities
Tier 1 Cities
Tier 2 / Tier 3
Specific Cities:
Tentative Monthly / Campaign Budget
-- Select --
Under ₹1 Lakh
₹1–5 Lakhs
₹5–10 Lakhs
₹10–25 Lakhs
₹25–50 Lakhs
₹50 Lakhs+
Campaign Timeline
Immediate (0–15 days)
1 Month
3 Months
Planning Stage
I confirm that the information provided is accurate and authorized
I agree to the Media Buyer Terms & Conditions
View Terms & Conditions
I consent to be contacted by Myon Ventures for media opportunities
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Terms & Conditions
