All Calling Cards 10137 Boynton Place Circle Boynton Beach, FL 33437 Phone: (954) 283-8933 (954) 283-8933 FAX: (561) 208-1053

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Card Price Quantity Total 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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Last Name _________________________ First Name _________________________ Title _________________________ Company _________________________ Address (billing) ________________________________________________________________ City _________________________ State/Province _______ Zip/Postal code _________________________ Country _________________________ Evening Phone (_____)_______________ Day Phone (_____)_______________ FAX (_____)_______________ E-mail _________________________

Payment Information:

[   ]   Check/Money Order Included [   ]   Credit Card If paying by credit card:   Credit Card Type: [   ] VISA   [   ] MasterCard Number __________________________________________ Expiration Date ____/________(mm/yyyy)

1. PRINT this form.
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3. IF FAXING, provide your credit card information.
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