DEBIT/CHECK CARD MARKETING PROGRAM
2008 Order Form
Order form for:
Contact
Credit Union Name
Phone Number
Fax Number
Email Address
Customization/Instruction
Item
Size
Quantity
2-Color or 4-Color
Price
Ship Stuffers To:
Company/Credit Union/Mailhouse
Address
City, State, ZIP
Attention:
Date each month stuffers need to arrive at destination:
Payment:
Please check method of payment
1. Please debit our Georgia central account.
Account #
Amount $
Arthorized Signature
2. Please bill the credit union
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