|
Important
- Write Clearly or Type In
|
|||||
ANNUAL BILLING INFORMATION This WILL NOT appear online. | |||||
Send our receipt and placement confirmation to this e-Mail address: ___________________________________________________________________________________________________________ (This address will NOT be given, sold or leased to 3rd Parties) Billing Street or P.O. Box: ___________________________________________________________________________________ City: ______________________________________________________________ State/Prov: ____________ Zip: _____________ |
|||||
BASIC LISTING INFORMATION This WILL appear online. | |||||
Suggest a New Category: ______________________________________________________________________________________
|
PAYMENT
OPTIONS The annual fee is non-refundable after your order
has been placed on ActiveSET.org.
|
OPTION
1 - Pay By Check
Mail the completed form with a U.S. Check or Money Order in U.S. Funds for the $100 annual fee payable to: ActiveSET.org 3335 NW 47th Terrace Gainesville, Florida 32606 |
OPTION
2 - Pay By Credit Card
I authorize Emissions Schematics to bill my
credit card $100 (USD) for the annual fee. ActiveSET.org is owned
and Cardholder's
First and Last Name as it appears on the front of the card: Thank
You ! ActiveSET.org will process your order immediately upon receipt. |