Please enclose a copy of this invoice with your payment.

eMarketing Association
40 Blue Ridge Dr. Charlestown, RI 02813


PHONE: 401.315.2194 FAX: 408.884.2461

REFERENCE # eCM01 - INVOICE

1 eMA eCourse - $72.00

TOTAL AMOUNT DUE THIS INVOICE $72.00

Please provide the following: Date__________________

Name__________________________________________________________________________

Address________________________________________________________________________

City______________________________________State_______________Zip_______________

Company:______________________________________________________________________

Company URL:__________________________________________________________________

Phone #:______________________________________ Ext.:____________________________

Email Address___________________________________Years of Marketing Experience: ______


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
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