POCKET PLANNERS PROMOTIONAL PROGRAM
2009 Order Form
Order form for:
Contact Name
Credit Union Name
Phone Number
Fax Number
Email Address
Imprint Information
(including logo):
Credit Union Name
Credit Union Address
Credit Union City / State / ZIP
Telephone
Fax
E-mail Address
Web Site
Color:
Quantity
Black cover / tan spine
Blue cover / burgundy spine
Blue cover / tan spine
Burgundy cover / blue spine
Ship To:
Credit Union/Mailhouse
Address
City, State, ZIP
Attention:
Date Materials Need to Arrive at Destination:
Payment:
Please check method of payment
1.
Please debit our Georgia central account.
Account #
Amount $
Authorized Signature
2.
Please bill the credit union
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