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CREDIT CARD AUTHORIZATION authorizes M. Gill Associates Inc. OR its dba Minority Business Enterprise Center MBEC to bill the credit card listed below for the following MEDWeek 2014 charges ITEM AMOUNT CARDHOLDER S NAME Please print as it appears on card CARD TYPE Please check one Visa Master Card CARD NUMBER EXPIRATION DATE BILLING ADDRESS CITY/STATE/ZIP TELEPHONE Email AUTHORIZED SIGNATURE TODAY S DATE Thank you for sponsoring and supporting the 32nd Anniversary of Minority Enterprise...
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Authorizes M is a form that grants permission or approval for certain actions.
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