Please Call 212-633-1317 or E-mail: orders@blindspot.com for subscription orders and inquiries.

Alternately, you can print this page, fill it out and Fax us at 212-627-9364, Or mail in this form with credit card information or a check made payable to "Photo-Based Art, Inc." Mail to: Blind Spot c/o Photo-Based Art, Inc., 210 Eleventh Avenue, NY, NY 10001 *Please Note: All checks must be in U.S. dollars, drawn from a U.S. bank*

Name: ______________________________________________________________

Company: ______________________________________________________________

Address: ______________________________________________________________

City: ______________________________________________________________

State: ______________________________________________________________

Zip: ______________________________________________________________

Country: ______________________________________________________________

Telephone: ______________________________________________________________

E-mail: ______________________________________________________________

Name and any message from sender(s):

Method of payment:

[ ] Check    [ ] MasterCard    [ ] Visa

Card No.:_____________________________ Expiration date: _________

[ ] 1 year U.S. $40 [ ] 2 years U.S. $80

[ ] 1 year Canada $55 [ ] 2 years Canada $110

[ ] 1 year foreign $75 [ ] 2 years foreign $150

Begin my subscription with: [ ] Issue 36   [ ] Issue 37