Name On the Card ______________________________________________

Credit Card # __________________________________________________

Expires  ________________________

*CVV2 # _______________________

First Name ____________________________________________________

Last Name ____________________________________________________

Company _____________________________________________________

Address ______________________________________________________

City __________________________

State _________________________

Postal Code/Zip  ________________

Country ______________________________________________________

E-mail ________________________________________________________

Promotion Code (5% off): _________________________________________

* The Credit Card Validation Code is a 3 or 4 digit security code printed on the
card. We use this code, as well as Address and Zip Code verification, to make
decisions on whether to accept charges. This increases our commitment to
protect consumers from fraud and reduces our exposure to fraud.

Fax Credit card info to: 800 317 2029

Or send by mail Money Order or Certified (Cashiers) Check:

Chicago Informer
551 Roosevelt Rd., # 101
Glen Ellyn, IL 60137