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Oceantemp Satellite Imaging
Fax/Mail orderform for Credit Cards

"Oceantemp South Inc."
Fax # 888-679-4223 or email to   info@oceantemp.com

*Please make check out to Oceantemp South Inc.

Card Type (Visa Discover Mastercard or Amex Etc): _______________________

Name as it appears exactly on card: _________________________

Address that goes with your credit card______________________

City: ____________________   State: ______________    Zip Code: ____________

Card Number: ______________________________________

3 Digit code on back (on front if Amex) ________________

Expiration Date: __________________

Phone Number _______________________________

E-Mail Address: ________________________________________

Region that you want to sign up for (please check one)

NE _________ OR Florida Bahamas MA_______

Username you wish to use ________________

Password you wish to use _________________

(username and password cannot be the same and are case sensitive)

Please make check out to Oceantemp South Inc.

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