BD+C 2013 Building Team Awards Payment Information

Payment Information ($250.00 per entry)

Credit Card Type_______________________________________

Cardholder's Name_____________________________________

Cardholder's Address___________________________________

____________________________________________________

____________________________________________________

Credit Card Number____________________________________

Expiration Date________________________________________

Amount______________________________________________

Company name_______________________________________

Authorization (if other than cardholder)

____________________________________________________

Today's Date_________________________________________

Check [  ] if you want a receipt.
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If paying by check, please make payable to "SGC Horizon"