Retail Dues Form

Fill out form below to pay Membership Dues on-line.  If you are paying by check, please click here to download dues form in Adobe PDF.


 
Company:
Name:
Title:
Address:
City: State: Zip
Phone:
Fax:
E-mail:
Schedule of Annual Dues
$30 per store in North Carolina and South Carolina
Number of North Carolina Stores
Number of South Carolina Stores
Total number of locations: x $30 = $
Credit Card Type:
Name as on CC:
Card Number:
Card Exp. Date 00/00
Card Security Code
Yes, I give CFIC persmission to charge my Credit Card for Retail Dues.
Enter Total to be charged: $

 

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