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Magazine Subscription Form - Design 1

 
Name
First
Last 
Email:
Phone:
Address: 
City, State, Zip Code: 
Country: 
Topic Selection:
Magazine
Select?
Yearly Fee
A
B
C
1
Sports Weekly Mania
$120.00
2
Men's Health
$144.00
3
Business Weekly
$240.00
4
Fast Cars Mania
$120.00
5
Holiday Wonders
$144.00
6
 
 
 
7
If you select more than one magazine, you get monthly fee discount of $10 x number of magazine.
 
$0.00
Please select the billing frequency: You get a further 5% discount for quarterly billing or 10% discount if you pay yearly. 
Total payment:
Billing frequency:
Annual Saving:
% saving:

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