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Complete the following order for
ADVERTISING MEMBERSHIP OF THE SEA-EX DIVE SITE
:

Please provide the following information:

Name
Title
Organization
Postal Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL

Please provide the following ordering information:

QTY DESCRIPTION
1 year Diving Section Advertising  @  US$75.00
.  
CATEGORY/SECTION OF YOUR CHOICE
 
YOUR KEYWORD CHOICE
1. 2. 3.
.    
BANNER Sea-Ex designed I will supply 
 

Please give a description of your products and services and any relevant information you would like included in your advertisement:

 

  BILLING

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Cardholder Name

Card Number
Expiration Date

*Australian companies please note that this is +GST

 

 
 


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