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International Subscriptions must be pre-paid in U.S. Funds. International orders are payable in U.S. currency by Credit Card or check drawn on U.S. bank.



To subscribe over the phone with your credit card, please
Call: 1-847-763-9581



If you do not wish to call, you may print this form and fax or mail it with your payment. Fax: 1-847-763-9606



Mail To:
Insurance & Technology
PO Box 1052
Skokie, IL 60076
United States


Paid Subscription Form

Subscribe now with a credit card via an online secure transaction.

Yes! I wish to receive Insurance & Technology at the term & price indicated below.


Subscription Rates:
 
        US: 1 year - 4 issues $ 65.00
        Canada: 1 year - 4 issues for $ 85.00 (includes GST)
        Foreign: 1 year - 4 issues for $ 295.00

Billing Information:

Credit Card Type:
Credit Card Number:
Expiration Date: Month: Year:
Name on Card:


Delivery Information:
First Name
Last Name
Title
Company
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Guarantee of Satisfaction: If you are ever dissatisfied with
Insurance & Technology, you may cancel your subscription at any
time and receive a full refund for all un-mailed issues.

We have put in place appropriate physical, electronic, and managerial procedures to safeguard and help
prevent unauthorized access, maintain data security, and correctly use the information we collect on-line
We will not sell, share or rent any financial information collected from you except as necessary to fulfill your
order.

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