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Insertion Order Form
All Fields Required*
All Fields Required*
As a convenience to our clients and in support of the "Go Green" initiative, we are providing a secure on-line payment system. When you Submit this form, you will be redirected to a Payment page which accepts, AMX, Visa, M/C, Discover and Paypal. If you prefer to send a check, close your browser when the Payment Page opens and send payment to Talahi Media Arts, P.O. Box 360, Prather, CA 93651.
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