Photo Mailing Form

This form is for Mail Orders or to accompany Photos

Mail to: American Media Trading Co., ATT: Joan Young, 906 Crestview Dr, Auburndale, FL 33823

Personal Information

First Name:

Middle Initial:

Last Name:

Street Address:

City: State: Zip Code:

E-Mail:

Vacation Rental Listing Information

User name: If you have already created your Listing, enter the User Name you selected on-line. Otherwise enter the User Name (6 to 10 letters and/or numbers) that you will use to access your Listing for updating and renewals.

Have you created your Listing yet?

Photo Scan and Upload Service:

Single Property Lising Price:

Have you already paid for the basic Listing on-line?

Total the fees selected above (subtract the Basic Web Ad Price if you have already paid that on-line) and enter the result below.
Net Amount due with Order:

Payment Information

Select Payment Method:

Enter Name as it appears on Credit Card or Checks:

Enter Credit Card Number:

Enter Expiration Date ( mm/yy ):

Confirm Amount to be Charged to Credit Card:

Cardholder Signature:_____________________________________

Additional Information and TEXT if needed:

Use your browser's print button, or select file/print to print this form for mailing. We suggest that you print an extra copy to keep for your records.

Press to clear this form AFTER printing.

 

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