Welcome To Viva La Paz
Visitor's Guide Mail-in Form

Please print and fill out the mail-in form completely. Mail
both the form and check or money order to the following:

Baja Communications Group
P.O. Box 4917
Laguna Beach, CA 92652
Attn: La Paz Visitor Guide


All charges are payable in advance and are nonrefundable.
Please allow 2 weeks for delivery.

    Name: __________________________________________________

    Address: ________________________________________________

    City: ___________________________________________________

    State: __________________________________________________

    Country: __________________ Zip/Postal Code: _______________


    email Address: _____________________________

    Phone Number: _____________________________

    Fax Number: _______________________________

    Cost: $10.00

    Order Total: ________

    Payment Type: ___ check ___ money order ___ credit card

    Credit Card Type: ___ VISA ___ MasterCard

    Card Number: __________________________________________

    Expiration Date: ________

    Name as Printed on Card: ________________________________

    Signature: ___________________________________

THANK YOU!


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