All Calling Cards
10137 Boynton Place Circle
Boynton Beach, FL 33437 |
Phone: (561) 282-6603
(561) 282-6603
FAX: (561) 208-1053 |
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ORDER FORM
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| Card |
Price |
Quantity |
Total |
| [ ] AA Real Minutes | $24.00 | ______ | $________ |
| [ ] Big Boss | $20.00 | ______ | $________ |
| [ ] MCI World Traveller | $12.50 | ______ | $________ |
| [ ] Penny Card | $5.00 | ______ | $________ |
| [ ] Penny Card | $20.00 | ______ | $________ |
| [ ] Power Minutes | $10.00 | ______ | $________ |
| [ ] Smart Card | $6.00 | ______ | $________ |
| [ ] Smart Card | $11.00 | ______ | $________ |
| [ ] Smart Card ( New ) | $6.00 | ______ | $________ |
| [ ] Smart Card ( New ) | $11.00 | ______ | $________ |
| [ ] Super Rate Canada | $10.00 | ______ | $________ |
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| Total: | $________ |
| If more then 10 cards, minus 10% discount: | $________ |
| DELIVERY OPTIONS:
[ ] E-Mail PINs (FREE)
[ ] Fax PINs (FREE)
[ ] Mail the cards ($2.00) | $________ |
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Please provide the following information about yourself:
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| Last Name |
_________________________ |
First Name |
_________________________ |
| Title |
_________________________ |
Company |
_________________________ |
| Address (billing) |
________________________________________________________________ |
| City |
_________________________ |
State/Province |
_______ |
| Zip/Postal code |
_________________________ |
Country |
_________________________ |
| Evening Phone |
(_____)_______________ |
Day Phone |
(_____)_______________ |
| FAX |
(_____)_______________ |
E-mail |
_________________________ |
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Payment Information:
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| [ ] Check/Money Order Included |
[ ] Credit Card |
| If paying by credit card:
Credit Card Type: |
[ ] VISA [ ] MasterCard |
| Number |
__________________________________________ |
| Expiration Date |
____/________(mm/yyyy) |
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