Magazine Subscription Form - Design 2



Magazine Selection:


Fashionate Diva
12 Months $30.00


Food Table
12 Months $30.00


All About Sports
12 Months $30.00




The Student Magazine
12 Months $25.00


Garden Mania
12 Months $25.00


Motor Fun
12 Months $30.00


Please select the billing frequency: Save 10% for yearly billing or
5% for quarterly billing.

Total Payment:
Billing frequency:


Customer Details

Title
First Name
Last Name

Phone Number
Email Address


Billing Address

Address Line 1
Address Line 2

City/Town
State/Province

Postal/Zip Code
Country


Delivery Address

Same as the billing address