Boston In-Water Boat Show

Credit Card Authorization Form

Date:
Exhibiting Company Name:
Card Holder Name:
Card Billing Address:
Card Billing City:
Card Billing State:		Card Zip Code:
Card Holder Phone:
Card Holder Fax:
Card Holder Email Address:
Credit Card Number:
Credit Card Expiration Date:		Card Type:
TOTAL COST:
Items To Be Purchased:	*You may select more than one by holding down ctrl & click
Please Read Statement Below**
Submittal of this form authorizes Vernon Promotions to charge the credit card provided for the TOTAL COST displayed.
Enter Anti-Spam Code: HT4K
			If you would like to download this form and fax it back to 978-777-2692 Click Here

Questions? Call Vernon Promotions at 978-777-4439