ORDERFORM

print out and fulfill this form, then send it
        by fax to ++49/9281/74119
        (from USA i.e. use: 011 49 9281 74119)

Order:

__ "Chatz" single panel subscription

__ "Juris" single panel subscription (check selected)

for print use.

the order is about

__  5 weeks, $80

__ 26 weeks, $312

__ 52 weeks, $416   (check selected)

the subscription rate factor is
__ 1.0    for      1- 20,000 avg. daily subscribers
__ 1.5    for 20,000-100,000 avg. daily subscribers
__ 1.8    over       100,000 avg. daily subscribers
   (check selected)
 
the amount of payment is $ __________
(weeks price x rate factor)


Charge through credit card: (Master)

Card Owner:   ________________________________

Card Number:  ________________________________

Card Verification Number: ____________________
(3-digit number printed on the back of your card.
It appears after and to the right of your card number.)

Valid thru:   ________________________________

Date:         ________________________________

Sign:         ________________________________

your email:   ________________________________

your address: ________________________________

              ________________________________

              ________________________________

You will receive the images as

__ TIF,  __ EPS,  __ PDF on CD by mail. (check selected)

Thank you for your order.
Your Team at comic-cartoons.com


PS.: we use this way by fax to receive your creditcard
information as safe way avoiding abuse.

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