Name: _________________________________________________________________________

Address: _______________________________________________________________________

City: _______________________________ State/Province: _____ Zip or Postal Code: __________

Email: _________________________________________________________________________

I would like to order

_____ a monthly subscription ($7.95 - credit card orders only)

_____ a one-year subscription ($79)

_____ a two-year subscription ($120)

_____ I am enclosing a check/money order in the amount of $__________ as payment for the item checked above.

_____ Please charge my credit card (circle one):     VISA    MasterCard    American Express    Discover

Name on card ___________________________________________

Card number ____________________________________________ Expiration Date ____________

Is your billing address the same as the address above? _____ Yes _____ No

If not, please provide your billing address below:

Address: _______________________________________________________________________

City: _______________________________ State/Province: _____ Zip or Postal Code: __________

Authorized Signature: ______________________________________________________________

Instructions
Please print this form and complete all the information required. Then send the completed form, along with your check or money order (if applicable), to

The MicroEnterprise Journal
Wahmpreneur Publishing, Inc.
P.O. Box 41
Sidney, New York 13838
USA

You will receive an email confirmation of your order and payment within two business days of its arrival in our office.