Subscription and Back Issue Order Form
Please print and complete the form below.
Mail to: Birmingham Parent, 700-C Southgate Dr., Pelham, AL 35124
Please Send Me:
_______ Subscription $36.00 (12 Issues)
_______ Back Issues ($5.00/issue) Month(s): (BASED ON AVAILABILITY)
(Please allow 4-8 weeks to receive your first issue)
__________________________________________________________________
Name:
___________________________________________________________________
Address:
___________________________________________________________________
City:
___________________________________________________________________
State:
___________________________________________________________________
Zip:
___________________________________________________________________
Phone:
___________________________________________________________________
Email:
___________________________________________________________________
Card Type: (Circle One) MasterCard Visa Discover AMEX
Credit Card#:
___________ - ___________ - ___________ - ___________
Expiration:
________ / ________
Signature:
___________________________________________________________________
Or send check or money order, made payable to Birmingham Parent, with this form to:
Birmingham Parent
700-C Southgate Dr.
Pelham, AL 35124
700-C Southgate Dr.
Pelham, AL 35124
