Please enclose a copy of this invoice with your payment.

eMarketing Association
91 Point Judith Road #129
Narragansett, RI 02882

PHONE: 401.315.2194 FAX: 408.884.2461

REFERENCE # EV/EB - INVOICE

1 SUPPORTING Sponsorship
The 2012 eM12 conference - San Francisco -
$995.00

TOTAL AMOUNT DUE THIS INVOICE: $995.00

Please print clearly the following information:

Date__________________

Name_________________________________________________________________________

Address________________________________________________________________________

City______________________________________State_______________Zip_______________

Company:______________________________________________________________________

Company URL:__________________________________________________________________

Phone #:______________________________________ Ext.:____________________________

Email Address___________________________________________________________________


Payment Method:

Visa ___ MasterCard ___ American Express___ Check___

Card Number_____________________________________________Expiration ______________

If Different From Above:

Name On Card__________________________________________________________________

Address________________________________________________________________________

City______________________________________State_______________Zip_______________

Signature:______________________________________________________________________

Mail a copy of this invoice with your payment to the address above. or fax it to: 408.884.2461
You will receive an email confirmation of this order.
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