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   COIN SHOWS

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   Submit your Payment Information here
3. Coin Show Name, Location & Date(s) *

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5. Credit Card Number *
6. Expiration Date *
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7. 3-digit Code on back of Credit Card *
8. Name on Credit Card *
9. Complete Billing Address *
10. By entering my initials, I agree to have my Credit Card charged $12 per show day  
11. OR, By entering my initials, I agree to place "www.coinshows.com" on all printed advertising for the show and agree to have my Credit Card charged $11 per show day  
12. Add any Comments here  

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