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Date:_____________ Name: _______________________________________________________
Street Address: __________________________________________________________________
Telephone: __________________________Email Address _______________________________
|TBAI 2013 Pins
|Please check one:
||_____I will pick up my order at the TBAI 2013 on August 22 - 24, 2013
_____Mail my order (First class in US; Airmail Canada & Overseas)
Mailed orders will be filled the week following TBAI.
We are unable to specify postage charges. You will be charged actual postage, packaging costs and $1.00 handling fee for your order.
||4131 State Route 9
||Plattsburgh NY 12901
Check or credit card for orders to be picked up at Registration August 23. Make checks payable to TBAI.
Payment by credit card required for orders to be mailed.
Charge my Visa or MasterCard, Discover or American Express (circle one):
Credit Card # __________________________________________
Exp Date: _________________
CVV2 (3-digit # on back of card)_________
Name as it appears
on the card: __________________________________________________
Signature of Cardholder ________________________________________ Date: ___________