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Important
- Write Clearly or Type In
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| ANNUAL BILLING INFORMATION This WILL NOT appear online. | |||||
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Send our receipt and placement confirmation to this e-Mail address: ___________________________________________________________________________________________________________ (This address will NOT be given, sold or leased to 3rd Parties) Billing Street or P.O. Box: ___________________________________________________________________________________ City: ______________________________________________________________ State/Prov: ____________ Zip: _____________ |
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| BASIC LISTING INFORMATION This WILL appear online. | |||||
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Suggest a New Category: ______________________________________________________________________________________
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PAYMENT
OPTIONS The annual fee is non-refundable after your order
has been placed on ActiveSET.org.
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OPTION
1 - Pay By Check
Mail the completed form with a U.S. Check or Money Order in U.S. Funds for the $100 annual fee payable to: ActiveSET.org 3335 NW 47th Terrace Gainesville, Florida 32606 |
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OPTION
2 - Pay By Credit Card
Cardholder's
First and Last Name as it appears on the front of the card: Thank
You ! ActiveSET.org will process your order immediately upon receipt. |