NAME:____________________________________________________
Mailing Address:___________________________________________________
City, State:___________________________________________________
Zip___________________________________________________
Charge my card below for (mark one):
___1 year delivered in Avoyelles Parish
___1 year delivered in Louisiana (out of Avoyelles)
___1 year delivered out of Louisiana, in USA
Credit Card Number___________________________________________________
Card Expiration Date___________________________________________________
Your signature__________________________________________________
____________________________________
Please allow two weeks for your first paper to arrive.
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