BRUSHWARE SUBSCRIPTION CARD
Print this form by clicking the button above; then complete and mail with your check to:
12Twelve Media Corp.
750-B NW Broad Street
Southern Pines, NC 28387 USA

Tell us about yourself:
Name:
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Title or Position:
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Company:
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Mailing Address:
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City: _____________ State: ________ Zip: _____________ Country: _____________
Tel: _____________ Fax: _____________ E-Mail: _____________


Please check one of the following:
___ Manufacturer ___ Supplier ___ Supplier and Manufacturer ___ Other

 
Choose your subscription:
 
USA
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Overseas
1 year:
___ $55
___ $70
___ $90
2 years:
___ $100
___ $130
___ $170
3 years:
___ $155
___ $190
___ $250

 

__ Check here if you wish to receive information on advertising in Brushware

HOW TO PAY:

1) Checks should be made payable to Brushware Magazine and must be in U.S. funds and drawn on a U.S. bank. Mail your check along with this completed form to:

Brushware Magazine
12Twelve Media Corp.
750-B NW Broad Street
Southern Pines, NC 28387 USA

2) Wire transfers should be sent to:

CITIBANK, N.A.
% BRUSHWARE/12TWELVE MEDIA CORP
MT. KISCO, NY 10549, USA
ABA# 021000089
ACCOUNT# 70855549
Thank you for your subscription!