Subscription Order Form - Nation's Courts Online 
Please print out form; fill in information below and return by email or fax (212-687-3779)
or postal mail (WANT Publishing Co. 420 Lexington Ave., Suite 300, New York, NY 10170).

Annual Subscription: 
[  ] Please enter subscription to Nation's Courts Online at annual rate of $195 (rate applies
     regardless of the number of users). I understand I may cancel at any time for full return
     of the unexpired portion.

[  ] Send monthly update of judicial nominations, confirmations and court vacancies to email
     address below. This free service is available only to Nation's Courts Online subscribers.

30-DAY FREE TRIAL. You do not need to send payment in advance. You will not be
billed until your 
free trial has elapsed, at which time you may cancel if you wish. 
Beyond that, you may cancel at any time for full refund of the unexpired portion. 


Method of Payment:
[  ] Payment Enclosed (Check payable to WANT Publishing Co.)         [  ] Bill Me / Organization 

[  ] Amex       [  ] Mastercard        [  ] Visa

Credit Card #_______________________________________ Expiration Date: ____________

Name on Card: _____________________________________ Security Code: _____________


Address Information:

Name: ______________________________________________________________________

Organization: _________________________________________________________________

Address: _____________________________________________________________________

City/State/Zip: _________________________________________________________________

Phone Number: _______________________________________________________________

Email Address: _________________________________________________________
                            (For notification of account activation only; not disclosed to third parties)

Email Address for Monthly Update: __________________________________________
                            (Include only if different from above)
                       

 
Enter Username and Password:

    User (Login) Name:
__________________________Password: _______________

      (Username/Password can contain 4 – 15 alpha and/or numeric characters)

   You will be notified by email when your account has been activated. Subject line will read
    "New User Details."

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