Click
here
for the
Directory
To visit our website
(click
on)
http://www.absolutelynautical.com
(Print this form)
Please complete
this form and send it with the information you want displayed on your
page and payment of
$125 (US) for 6 months or $250 for 1 year.
Visa, MasterCard,
Check By
Fax: Photo copy your check and fax with this form
made payable to Crown Eagle, Inc..
|
Company Name: ________________________________ |
Corporation: Yes ___ No ___ |
|
Name: __________________________________ |
Corporate Officer: Yes ___ No ___ |
|
Address (No P.O. Boxes) ______________________________________________ |
|
|
Mail Address (If Different) _____________________________________________ |
|
|
City: ____________________________ |
State: _____ Zip Code: ___________ |
|
Phone: ____________________ Fax: _________________ |
E-mail: ______________________ |
Please Note: Your credit card order will be processed by AIM
Marketing their name will appear on your credit card statement for
the amount of this purchase.
(A $20 fee will be charged for re-processing of charge backs)
Card Name: .........Master Card ___ Visa ___
Account #: ________________________________________ Expiration Date ________
Cardholder Name: (print name) ___________________ Signature: _________________________
Click
here
for the
Directory
To visit our website
(click
on)
http://www.absolutelynautical.com