Fax or Mail Sign-up
Please PRINT and fill out this information:
You may register with Cubs
Anonymous by FAX or MAIL
Include credit card number or
Send personal check or money order for:
| Membership Kit |
$25.00 |
| Shipping & Handling |
$ 4.00 |
| Total |
$29.00 |
Illinois residents add $2.13 sales tax for a total of $31.13
Allow 2-3 weeks delivery.
Mail today to:
Cubs Anonymous
9333 Lavergne
Skokie, IL 60077
Cubs Anonymous fax number is: 847-674-2215
FULL NAME
________________________________________________
MAILING ADDRESS __________________________________________
CITY_______________________________ STATE_____ ZIP _________
PHONE NUMBER (with area code) ______________________________
CIRCLE PAYMENT METHOD: VISA MASTERCARD AMEX
CREDIT CARD NUMBER ______________________________________
CREDIT CARD EXPIRATION DATE ______________________________
NAME ON CREDIT CARD _____________________________________
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