Credit Card Form

Purchase by Credit Card Form Once you have purchased an item online, fill out this form and CLICK TO PRINT then fax to 888-382-6951 (int'l 478-987-1836)
Purchasers Name		Subscription Wannabe Package Classified Last Load Ageless Ag Cat Low and Slow Flight At Lower Levels Guide to Flying SA My 100 Loves Crop Duster Video/DVD Spreading The Facts CD Library	Ag-Cat A Model Ag-Cat B Model New Ag-Cat Turbine AT-401 AT-402 Turbine AT-502 AT-602 AT-802 Turbine Clipped J3 Cub M18A Dromader Flying Dromader Piper Pawnee Stearman Radial Thrush Turbo Thrush Weatherly
Company Name
E-mail Address
Phone
Credit Card Number	Exp. Date
Source Code	(3 addition digits on back of card)
Card billing address (if different)
Zip
Name that appears on card:
Comments/Special Instructions?

Purchase by Credit Card Form