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THE GEORGIA SPORTS & EVENT MARKETING CORPORATION
Billing Authorization
Name:______________________________________________________
Company (if appicable):____________________________________
Billing Address: _____________________________________________________________
_____________________________________________________________
Phone Number:_____________________________________________________
Fax:_________________________________________________________
Email:________________________________________________________
I hereby authorize Georgia Sports & Event Marketing Corporation (GSEM) to forward an invoice which will outline the program elements of my
order. I have read and agree to the GSEM Terms and Conditions and other elements as stated on my invoice and / or Contract. I also understand and agree to GSEM’s cancellation policies as outlined.
Signed:______________________________________________
Date:________________________________________________
Printed Name:________________________________________
Title (if appicable):_________________________________
Please fax or email this completed form (along with Terms and Conditions form) to:
770-518-1326 or Jim@GsemCorp.com.
The Georgia Sports & Event Marketing Corporation
295 Saddlebrook Terrace
Roswell, GA 30075
Phone: 888-704-3140: 770-518-5558 Fax: 770-518-7363
Email: jim@gsemcorp.com
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