*Please make check out to Oceantemp South Inc.
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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: ________________________________________
you want to sign up for (please check one)
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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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