Fax-Back Subscription Form

Please print out this page, fill in the blanks and fax back.

____ Yes, start my subscription to Indiana Business.

____ Bill me for $19.95 (12 issues).

____ Payment enclosed (mail to address below).

 

Name ___________________________________________________________________

Title ____________________________________________________________________

Company ________________________________________________________________

Address _________________________________________________________________

City, State and ZIP _______________________________________________________

Phone ___________________________ Fax ___________________________________

Primary business (check one):

 _____  Manufacturing  _____  Wholesale Trade
 _____  Agriculture  _____  Banking or Finance
 _____  Mining  _____  Insurance
 _____  Construction  _____  Real Estate
 _____  Transportation  _____  Service or Institution
 _____  Communications  _____  Government
 _____  Utilities  _____  Other (please specify)
 _____  Retail Trade        _______________________

 

Fax this form to 317.692.4250

If you prefer, mail this form with payment to 1100 Waterway Blvd., Indianapolis, IN 46202
Visa and MasterCard accepted

For more information, phone 800.473.2526