AMERICAN WINDOW CLEANER SUBSCRIPTION CARD
Print this form by clicking the button above; then complete and mail with your check to:

American Window Cleaner
12Twelve Media Corp.
750-B NW Broad Street
Southern Pines, NC 28387 USA

Tell us about yourself:
Name:
 ________________________________________________
Title/Position:
 ________________________________________________
Company:
 ________________________________________________
Mailing Address:
 ________________________________________________
City: _____________ State/Province: ________

Zip/Postal Code: _____________ Country: _____________
Tel: _____________ Fax: _____________ E-Mail: _____________

How may we contact you for confirmation? ___ Telephone ___ E-Mail

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USA
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1 year:
___ $55
___ $70
___ $90
2 years:
___ $100
___ $130
___ $170
3 years:
___ $155
___ $190
___ $250

 

__ Check here if you wish to receive information on advertising in American Window Cleaner

HOW TO PAY:

Please print this form and mail along with your payment to:

American Window Cleaner
12Twelve Media Corp.
750-B NW Broad Street
Southern Pines, NC 28387 USA

1) Checks or Money Orders should be made payable to American Window Cleaner and must be in U.S. funds and drawn on a U.S. bank.

2) Credit Card Payments:

Type of Credit Card (Visa, Mastercard, etc.):
__________________________________________
Card Number: __________________________ Exp: ____/_______
Name on Card:
 __________________________________________
Billing Address: (if same as shipping address, check here _____ )
____________________________________________________
City: _____________ State/Province: ________

Zip/Postal Code: _____________ Country: _____________
Thank you for your subscription!