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Please charge my credit card for the cost of my eBrochure membership until I cancel my participation in writing. Written notification of cancellation must be received at AHS by fax or mail prior to the 1st day of the month.
Credit Card Type:____________________
Credit Card Number:______________________________
Credit Card Expiration Date:____________________
Monthly Amount:____________________
One-time Setup Fee:____________________
PRINT the name on the card:______________________________
Hotel Name:______________________________
Hotel Phone:____________________
Signature:______________________________ Date:__________________
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