PLEASE PRINT CREDIT CARD AUTHORIZATION FORM, COMPLETE AND
RETURN VIA FAX TO (617) 876-2617.
QTY |
DESCRIPTION |
AMOUNT (USD $) |
Module One: Fundamentals |
$ 740
|
|
Module Two: Policy & Strategy |
$ 845 |
|
Both Modules |
$ 1,380 |
|
TOTAL: |
For billing questions, please contact AIRINC Accounting:
Tel: +1 617 354-2133
Email: invoicing@air-inc.com
| To be completed by the cardholder. | ||
|
||
| NAME (Please PRINT name as it appears on card) | ||
| COMPANY NAME | ||
| PHONE NUMBER | ||
| Cardholder acknowledges receipt of goods and/ or services in the amount of the TOTAL shown hereon; and agrees to adhere to the obligations set forth in the Cardholder's Agreement with the Card Issuer. | ||
| CREDIT CARD NUMBER | ||
| CARD EXPIRES | ||
| CARDHOLDER SIGNATURE | ||
| TODAY'S DATE |