myra Community of Care Order Form

We are delighted that you have chosen to support the SHCG FEIF Community of Care Project. In order to facilitate entry of your services into the Myra app please complete this form with details of your requirements. The sales team are always happy to help, please email sales@myliferaft.com if you need assistance or further information.

Duration of Placements will be for 6 months as a part of the SHCG FEIF Community of Care Project

* Indicates required question

Your Company Name

Company Contact Person

Contact's Number

Contact's Email

Company Website

Company Social Media Tags

Resource Title (word count 12)

Resource Description (word count 40)

Resource Content (Recommend 1000 or less)

Website address for customers

Contact phone number for customers

Please upload a high resolution image (max 3 files) Max 1MB each to include your logo

In which category of the myra app would you like your information to feature?

Please indicate in which location your service/product is applicable to

Applicable across England Local to Isle of Wight Local to Southampton Local to Portsmouth

If you would like to include a special offer to myra customers please detail below or contact sales@myliferaft.com for further details

Would you like to add more than two resources (fee applicable)

Would like Social Media Promotion (fee applicable)

Are you interested in Affiliate Marketing

Thank you for placing an order for the creation of a resource within the myra app or engagement with other marketing opportunities brought to you by myra. A member of the sales team will be in touch soon. By submitting this request you agree to our Terms and Conditions Sales team can be contacted on sales@myliferaft.com

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myra Community of Care Order Form

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