Patsy's On-line Advertising Payment Form

ISSUE

 DEADLINE

 Approx. Mailing Date

WINTER ISSUE

DEC. 1st

JAN. 1st

SPRING ISSUE

MAR. 1st

APR. 1st

SUMMER ISSUE

JUNE 1st

JULY 1st

FALL ISSUE

SEPT. 1st

OCT. 1st

 

Ad size    

Other Description     

Name        

Company Name (if any)           Website address (if any)    

Address         (If using a credit card, please use your billing address for that card)

City           State       Zip

Phone with area code     

Email      

Type of Card  

When paying by Paypal, please put X's in the Card # box below......then send your Paypal payment using patsysmag@aol.com  or  patsyspage@aol.com   for your payment.

Card #

Name as it appears on card  

Expiration Date 

Security Verification Number  

When paying by Paypal, please use patsysmag@aol.com  or  patsyspage@aol.com   for your payment.

 

      Total Payment $     


PATSY'S MAGAZINE

4215 SE 11th Place, OCALA, FL 34471
Phone (352) 694-5619

 

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