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First Name _______________________________

Last Name _______________________________

Street Address* ___________________________
*If paying by credit card, must be billing address

City_____________________________________

State____________________________________

Zip___________       Phone_______________

Visa ___ MasterCard ___

Card Number_____________________  Expiration  ____

If paying by check, please make it out to Sheila Allee Communications
and mail to:

236 Muirfield
Meadowlakes, TX 78654

Phone: 512-983-7636