Learn to live
with allergies
and asthma.
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subscription
now!
Coping® with Allergies & Asthma
Subscription Request Form
Print this Form, fill it out and place in an envelope along with your check,
money order or credit card information, and mail to: Coping® with
Allergies & Asthma, P.O. Box 682268, Franklin, TN, 37068-2268
Please note: Forms received without payment or credit card information cannot be processed.
Name:
Organization:
Address:
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Country
USA $13.95 for one year (5 issues)
USA $25.00 for two years (10 issues)
Canada/Foreign $28.00 (U.S.) for one year (5 issues)
Canada/Foreign $55.00 (U.S.) for two years (10 issues) This is a renewal
Payment Enclosed
Please charge to my Visa Mastercard
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Signature:
Date Signed:
For fast credit card service, fax this form to: (615) 794-0179
FOR TELEPHONE CREDIT CARD ORDERS CALL (615) 791-3859
8:30 - 11:30 am, 1:30 - 4:30 pm CT, Monday - Friday