Magazine Order Form
Name
First:
Last:
Mailing Address
Address 1:
Address 2:
City:
State:
Zipcode:
Magazines
News Week $53.95
Time $25.95
Sports Illustrated $36.95
Internet World $39.95
Billing Address
Billing same as Mailing
Address 1:
Address 2:
City:
State:
Zipcode:
Payment type
US Mail
Credit Card Online
Credit Card information
Card Type:
Visa
Master Card
Discover
Card Number:
Experation Date :
(mm/yyyy)
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