Pug Talk Gift Subscription

TO:

Name: _________________________

Address: _______________________

City: __________________________

State: ______ Zip Code: ___________

Country: _______________________

From:

Name: _________________________

Address: _______________________

City: __________________________

State: ______ Zip Code: ___________

Country: _______________________

We accept Visa and Mastercard.  If paying by credit card please provide the following information.

Credit Card: _____________________

Card Number: ___________________

Expiration Date: _________________

Signature:_______________________

Credit card orders are accepted by fax or by mail.  Our fax number is (715) 424-7847.

Credit card orders will be billed on your statement from VIP Publishing.

If paying with a check or money order or mailing a credit card payment, send to:

Pug Talk

5031 Plover Road

Wisconsin Rapids, WI 54494-9705