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Advertising Payment Form

Advertising Credit Card Authorization, please fill out the following Secure-Online order form.

All areas with asterisk (*) MUST BE FILLED.

All payments are non-refundable once submitted.

  • Advertising Information

  • Billing Information

  • United States Canada Other
  • Mailing Information (If Different)

  • United States Canada Other
  • Credit Card Information

  • VISA MasterCard American Express Discover

    NOTICE: No ATM/DEBIT Cards Accepted

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  • Please note that we do not accept multiple-pay orders, Debit Card or Electronic Check transactions.

    In addition, we are not responsible for any overdraft fees or other bank charges you may incur as a result of your advertising purchase.

  • Notes

  • ***YOU ARE REQUIRED TO FILL THE FOLLOWING TO SECURELY SUBMIT THIS FORM:

  • Electronic Signature & Verification

  • By submitting this form I hereby authorize The Canine Chronicle to keep my credit card payment information on file.