|
|
Amt
|
|
Title
|
|
|
|
Color Inside Front Cover (1x/year - $500, 4x/year - $450, or 12x/year - $400)
|
|
|
|
Color Back cover (1x/year - $500, 4x/year - $450, or 12x/year - $400)
|
|
|
|
Color Inside newsletter (12x/year - $150)
|
|
|
|
B/W Inside newsletter (12x/year - $100)
|
|
|
|
B/W Business Card (12x/year - $50)
|
|
|
|
Inserts (1x/year - $150, 4x/year - $100, or 12x/year - $75)
|
|
| Comments |
You have characters left
|
|
|
First Name:
|
|
|
Last Name:
|
|
|
Address:
|
|
|
City:
|
|
|
State:
|
|
|
Postal Code:
|
|
|
Country:
|
|
|
Telephone:
|
|
|
Email:
|
|
|
PAYMENT DETAILS
Please select your method of payment and provide billing information if paying by credit card. Fields marked with are only required for that specific payment type. |
|
|
I prefer to pay by Credit Card
|
|
Card Type:
|
|
|
Your Name
(as it appears on the card):
|
|
|
Card Number:
|
|
|
Billing Zip:
|
|
|
Expiration Date:
|
|
|
|
|
I prefer to mail a check |
A printable confirmation will be displayed upon completion. Please print and mail it with your check to:
4585 Hilton Parkway, Suite 100
Colorado Springs, CO 80907
719-592-1800
|
|
|
Payment Terms
Please check the box below to accept payment terms
I have read and agree to these terms.
|
|
REVIEW AND SUBMIT
Please review your information above and click "submit" below to securely process your payment to:
4585 Hilton Parkway, Suite 100
Colorado Springs, CO 80907
719-592-1800
|
|
|
|
|
