Discount Card Online Order Form

Group Name: (How you want it to appear on your card)

                                            

Price you are going to charge for each card
Expiration Date (To be placed on the card)   

Contact Name & Address

Your Name   Email (optional)
Address
City     State       Zip Code 

Shipping Address (if different from contact address)
Name
Address 
City     State        Zip Code

Businesses & Offers to go on the back of each card

(Please type exactly how you would like them to appear on the card, abbreviate where possible, 60 character maximum per line)

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2

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Total number of cards ordered
How would you like your proof sent? (Required, please pick one)
Email (easiest)  
Fax Number ( your fax must be turned on, we will not ask you to turn it on

Terms of Agreement
  • Permission must be obtained from all businesses
  • Total of payment due 30 days after receipt of the cards
  • A late fee will incur an additional 20% fee onto the total
  • no unused cards can be returned

If you have any comments or questions about this order please enter below.