Cemetery Database Order Form

Date:

  

Name:

  

Organization:

  

Address:

  

City:

   State:   Zip Code:  

Telephone No:

  

E-Mail:

  

 

 

Price: $49.95 Indicate Payment Method Below

___ Check
___ Money Order
___ Visa
___ MasterCard
___ American Express

 Credit Card Number: ____________________________________ Expiration ________

Authorized Card Holder Signature: ___________________________________________

Date: _________________

 

 

 

Send To:    ADvantage Design Services
                  2515 Ivy Stone Trail
                  Buford, GA 30519

 

 

 

 

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