 |
|
| |
|
|
| |
|
|
| |
 |
enter your zip code
|
|
| |
|
| |
|
|
|
SUBSCRIBE NOW! All you need to do is print this page, fill out the form below, and send it to the address below with your chosen form of payment. You'll receive Quest at the next
scheduled mailing.
Mail to: |
QUEST
Muscular Dystrophy Association
3300 E. Sunrise Drive
Tucson, AZ 85718-3208 |
____ check _____ money order (U.S. funds only)
| ____ 1 year - $15 (U.S.) |
|
____ 1 year - $24 (outside of U.S.) |
____ 2 years - $24 (U.S.)
|
|
____ 2 years - $37 (outside of U.S.) - 20% savings |
| ____ 3 years - $32 (U.S.) |
|
____ 3 years - $50 (outside of U.S.) - 30% savings |
Prices Effective January 2009.
Name: ____________________________________________
Address: _________________________________________
City: __________________________ State: __________ Zip: _________________
Credit Card: ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___
___
Signature: ______________________________________ Exp. Date:___ ___ /
___ ___
(required for credit card orders)
|
|
|
|
|
