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PLEASE
PRINT THIS FORM AND FAX TO: +1
540 723 6628
| Company
Details |
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| Name: |
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| Position: |
Department: |
| Company: |
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| Address: |
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| City: |
State: |
| Country: |
Postcode: |
| Tel#: |
Fax: |
| Email: |
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| Website: |
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| _____ |
12-Month Rate
- US$ 50
Now only
US$ 25 |
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Starting Date:
__________________ |
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| Payment
Details |
| _____ |
Check enclosed (issued to 'Gedoran America
Limited' in US$,
drawn on US branch) |
| _____ |
Bill my Credit Card: American Express / MasterCard / VISA
(please circle) |
| Acct#: |
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___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ |
| Expiration Date: ___ ___ / ___
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| Name on Card:
__________________________________________________ |
| Signature:
_________________________________________ |
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| Fax
form to: +1 (540) 723-6628, or by mail to: |
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| Gedoran
America Limited |
| P.O. Box 3431 |
| Winchester,
Virginia 22604 |
| Tel#:
+1 540.723.6628 email: editor@ifriction.com |
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