The China Connection: AMERICAN EXPRESS FAX FORM

PLEASE PRINT THIS FORM AND FAX IT TO OUR
BRANCH OFFICE AT (305) 931 5448 USA.
UPON CONFIRMATION FROM AMX, YOU WILL BE NOTIFIED BY EMAIL, OR FAX.

Please select contract:
Membership fee:
$ 330.00 three months contract

Name card holder:

Account number

Date expires:

I authorize the China Connection to charge
my AMX credit card in the amount of:

Signature___________________________

THANK YOU ONCE AGAIN FOR YOUR CONFIDENCE IN THE CHINA CONNECTION.
WE WELCOME YOU TO THE WORLDWIDE MEMBERSHIP
OF THE CHINA FACTORY ASSOCIATION.

Please select contract:	Membership fee: $ 330.00 three months contract
Name card holder:
Account number
Date expires:
I authorize the China Connection to charge my AMX credit card in the amount of: Signature___________________________