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First Name:
Last Name:
Present Email:
UserID Email:
@aslmail.com
Password:
(Password must be at least 8 characters
and not greater than 15 characters in
length. No spaces orsymbols allowed,
only letters and numbers.)
Verify Password:
AIM ScreenName:
S-Videophone #
D-Videophone #
I wish to be billed:
$20 - 1 year (with credit card billing only)
$40 - 2 years (with credit card billing only)
$20 - 1 year (with money order only)
$40 - 2 years (with money order only)
Payment:
Money Order
Cashier Check
Business Ck
Write and Send to:
Deaf Newspaper, LLC
P.O. Box 75626
Colorado Springs, Colorado 80970-5626
Visa/MasterCard
Credit Card #
Visa
MasterCard
Credit Card Expired Date:
Month:
01
02
03
04
05
06
07
08
09
10
11
12
Year:
2008
2009
2010
2011
2012
2013
2014
Your Zip Code
