SHARE DRAFT CHECKING PROMOTION
2010 Order Form
Contact:
Credit Union Name:
Phone Number:
Fax Number:
Email Address:
Item
Quantity
Price
Design #
Statement Stuffers
Posters 8.5" x 11"
Posters 11" x 14"
Tent Cards
Customization/Instruction (five lines of type included in basic price)
Ship To:
Company/Credit Union
Address
City
State
ZIP
Attention:
Payment:
Please check method of payment
1. Please debit our Georgia Central account.
Account #
Amount $
Authorized Signature
2. Please bill the credit union
