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To order by mail or fax, please print this page and fill out the requested information.

Your name: ________________________________

Street Address: _____________________________

City, State, ZIP: _____________________________

Area Code and Telephone Number: ( ) (If we need to contact you the old fashion way).

Email Address: ______________________________ (Make certain you fill this out)

Please check one of the following:

__3-Months @$29.95; __6-Months @$49.95; __1-Year @ $79.95; __2-Years @$139.95

Check one of the following:

___ Check or money order is enclosed.

___ Credit Card (Please check one of the following)

___ Visa ___ Master Card ___ American Express ___Discover

You must fill out the following information to complete your order:

Credit Card Number: ________________________________ Expiration Date: ________

Name on credit card: ________________________________

Your signature: _____________________________________ Date:______________

Mail this form and your payment to:

The Indicant.Net

P.O. Box 5361

Granbury, Texas 76049

Or if paying by credit card, you can fax this form to

817-579-0356

©All material contained in this Web site is copyright protected. Any redistribution of any information in this Web site is expressly prohibited unless written authorization is granted by the publisher of Indicant.Net.

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