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Membership request from
Mail to:  AuthorsDen.com  PO Box 339  Ramona, CA 92065  Phone: 619-270-1212		Order Number: 9
Method of Payment
Check Make Check or Money Order payable to: "AuthorsDen.com" Credit Card Type: Mastercard Visa AMEX Discover Credit Card Number: _______________________________ Exp. Date: ___/______ Billing Address: _________________________________________ _________________________________________ Telephones: Daytime: (____) ___________________ Evening: (____) ___________________
Annual Membership Plans
Quantity   Description   1-Year (Credit Card or Checks) ______ Annual Bronze Membership Plan   $ 50.00 ______ Annual Silver Membership Plan     $ 100.00 ______ Annual Gold Membership Plan   $ 200.00 ______ Annual Platinum Membership Plan   $ 800.00 Total: $________

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