|
||
|
TO JOIN PAIGEBOUND VIA FAX -Type in the information as needed in the spaces below. When you are done - hit PRINT on your computer and then just FAX the form to the number at the bottom of the page.
Your access code will be sent to you via e-mail withen 24 hours. FAX LINES ARE OPEN 24 HOURS A DAY •• 7 DAYS PER WEEK |
| YOUR NAME | |
| STREET ADDRESS | |
| STREET ADDRESS continued | |
| CITY | |
| STATE | |
| ZIP CODE | |
| COUNTRY | |
| YOUR E-MAIL ADDRESS REQUIRED | |
| CREDIT CARD (choose one) | M/C VISA DISCOVER AMEX |
| CREDIT CARD NUMBER | |
| EXP DATE | |
| TOTAL AMOUNT YOU OWE | $ |
| ANY SPECIAL NOTES OR COMMENTS -TYPE HERE |