Home

Payment Form

Payment Form

Payment Form

Full Name:  
Organization:  
Street Address:  
City:  
State / Province:                                
County:             
Zip Code:  
Tel:  
Fax:  
Email:        
Credit Card Type:  
Credit Card Number:    
Expiration Date:     
Amount Of Charge US $:  
The number Of Insertions:  
Advertisement Size:  
Type Your Advertisement:  
Type Of Advertisement:  Printed - Or - Online

 

We Accept:

 

 

 

Yes, I / We hereby authorize the Beirut Times Publishing Company Inc., to charge my credit card account for Subscription or Advertisement payment.