LISC

The Long Island Sportsmen's Courier, Inc.

Community Newspaper

Copyright 2002

Please print a copy of the following form and mail to:

The Long Island Sportsmens Courier

PO Box 415

Malverne, New York 11565

First Name:_______________ Last Name:___________________________

Street Address:______________________________________________________

City:_______________ State:_______________ Zip Code:_____________

Telephone Number:(______) _________-___________________ Date:_____/____

Email Address:______________________________________________________

Choose from the following subscriptions(check only one):

0 Printed Only $10.00 For Five Issues 0 Website Only: $5.00/Annual 0 Both For $12.00

Payment by: 0Charge Card 0Mail in checkwith application form

Dollar Total: $_________________________ Check # :___________________

Credit Card: 0Visa 0MC 0Disc Amex

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Expiration Date:_______/________/__________ Dollar Total: __________________

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Please place a check for your main area(s) of interest 0Competitive Shooting 0 Self Defense 0Hunting 0 Trap, 0Skeet & Sporting Clays 0 Junior Competitive Shooting 0 Politics 0 Aviation 0 Racing 0. Also, please tell us how we can better serve you. We appreciate your suggestions!

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