Billing/Shipping Information
Please complete this information and include it with your faxed or surface mailed order.
Name ____________________________________________________ Organization ____________________________________________________ Address ____________________________________________________ ____________________________________________________ City, State, ZIP ____________________________________________________ Phone ____________________________________________________ Email Contact ____________________________________________________ Payment ___ Check/Money Order ___ VISA ____ MasterCard Name on Card ____________________________________________________ Card Number ____________________________________________________ Expiration Date ______________
Verification Code
__________________ Signature ____________________________________________________ Billing Address
(if different from shipping address above)
Copyright © 2007–2008 iWrite Publications Inc. All rights reserved.
iWrite Publications Inc.
PO Box 10923, Chicago, IL 60610-0923
Phone or fax your order toll free at (888) 659 2882