Makeworksheets.com Offline Fax Sign-up Form

Makeworksheets.com Fax Signup Form

This form should only be used if you would like your credit card be processed off-line. Please complete the form below. The cost of 1 year (12-month) membership is $29.99 (U.S. Dollars). Please allow 1 business day for your order to be processed.

Please fax this form to: (845) 913-1492

Printable Version

Account Information:

Billing Information:

My email address is:

_____________________________________

Choose a password:

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After the form is faxed to our offices, you will receive an email confirmation when your account was successfully setup. Your credit card will be billed $29.99 (USD) at the time of account setup.

Name: ___________________________________

Company/School: ___________________________

Address: _________________________________

City: ____________________________________

State: ___________________________________

ZIP Code: ________________________________

Country: _________________________________

Credit Card Payment Information:

Name on Credit Card: ________________________________

Credit Card Number: _____________________________

Credit Card Expiration Date: _________________________

Credit Card Type: Circle One

American Express, Discover,

Mastercard, Visa

Please fax this form to: (845) 913-1492