Inclusion Daily Express -- New account

Inclusion Daily Express Logo

International Disability Rights News Service
Click here for today's headlines

Keeping advocates informed, inspired and connected since 1999.

Starting a new account to republish Inclusion Daily Express articles

This is the place to establish an account so you can reprint Inclusion Daily Express articles on your website, newsletter, or email group.

Welcome!

You can either fill out this page to set up your account on line, or click the button at the bottom of the page to print this form to fax or mail.

Privacy Policy: All information you send will stay private and confidential and will NEVER be given, sold, or shared with anyone for any reason without your permission.

*First name:
*Last Name:
Title:
Organization:
*E-MAIL ADDRESS:
*Mailing Address:
*City:
*State/Province:
*Zip/Postal Code:
*Country:
*Phone:
Fax:
Website Address:

If the billing information is different from that listed above, please fill in the following:

First Name:
Last Name:
Organization:
Address:
City:
State/Province:
Postal/Zip Code:
Country:
Daytime Phone:
Fax:
E-mail:

6. Which payment method works best for you or your organization?
Pay with credit card:

Name on credit card:
Type of card:
Expiration Date: (mm/yy)
Card Number:

Pay by check, money order or purchase order (we will send you a billing statement at the end of the month)

Any comments or questions?

Thank you!
[Note: When you click on the next button, you may get a message telling you the security certificates do not match. This is normal because I am using my webhost's (Interlink Advantage) secured line. You may click on "accept", confident that your information is secure. As an alternative, you may call 509-326-5811 to provide that information, or print this form to mail or fax to 509-472-3220.]

Did you have any problems with this form?
Click here to contact the web administrator

---

Get your news here!