SAVASAURUS MARKETING PROGRAM
2012 Order Form
Order form for:
Contact
Credit Union Name
Phone Number
Fax Number
Email Address
CU Asset Size (check one)
Annual Fee
Less than $5 million
$105
$5 million to $25 million
$175
$25 million to $75 million
$245
$75 million and up
$350
Payment:
Please check method of payment
1. Please debit our Catalyst Corporate FCU account.
Account #
Amount $
Authorized Signature
2. Please bill the credit union
