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Page 40 FEBRUARY 2017 | RETAILERS FORUM MAGAZINE

Company Name ______________________________________________

Individual Name ______________________________________________

Mailing Address ______________________________________________

City/State ___________________________________Zip ____________

Type of Business _____________________________________________

Phone _______________________ Fax __________________________

USA Delivery

Includes Shipping & Handling

o Sample Copy ..............................$10

o Subscription (24 Issues) ..............$60

CALL: 800-635-7654 • Fax 631-754-0630 • www.forum123.com

o MONEY ORDER o CHECK o CREDIT CARD

Mail Check or Money Order to: Forum Publishing • 383 E. Main St. • Centerport, NY 11721

Card No._____________________________________Exp ___________

Signature __________________________________________________

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