Secure Payment Form – Dupont Values Website

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By submitting this form I am giving Lat 30 Communications and Design my permission to publish my ad in the DuPont Values. I agree to hold harmless Lat 30 Communications & Design "from and against claims, damages, losses, and expenses, including but not limited to attorney's fees, arising out of or resulting from the ad I am placing in the DuPont Values." I understand my credit card will be kept on file for future ads I request to run. I understand I may cancel my ad before the 15th of the preceding month the ad is scheduled to run.