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| ___ Two Year Subscription Beginning with | (Qtr)____/(Yr)_____ | $400.00 | |
| ___ One Year Subscription Beginning with | (Qtr)____/(Yr)_____ | $250.00 | |
| ___ Individual Quarter | (Qtr)____/(Yr)_____ | $ 75.00 | |
| ___ I'm enclosing a check in the amount of: | $ _________________ | ||
| ___ Please charge my credit card: | ___ VISA ___ MasterCard | ||
| _______________________________________ | _____/_____ | ||
| Card Number | Exp. Date (mm/yy) | ||
| _______________________________________ | |||
| Your signature | |||
| Billing Address | |||
| _______________________________________ | |||
| Name as it appears on your credit card (please print) | |||
| _______________________________________ | |||
| Billing address | |||
| _______________________________________ | ___________________ | ||
| City, State | Zip | ||
| _______________________________________ | ___________________ | ||
| Phone | Fax | ||
| Mailing Address (if different from your Billing Address) | |||
| _______________________________________ | ______________________________ | ||
| Name | email address | ||
| _______________________________________ | |||
| Mailing address | |||
| _______________________________________ | ___________________ | ||
| City, State | Zip | ||
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| FAX your credit card
order to: 503-827-7242 or, mail your check (or Visa or Mastercard) order to: Jan Davis JT Research P.O. Box 8705 Portland, OR 97207 |
Or contact our office at: |
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