AirRestore USA, Inc. 11375 Robinson Drive NE . Suite 109 Minneapolis, Minnesota 55433 612.210.7008 l P 612.465.4616 l F www.AirResoreUSA.com
ORDER FORM
Personalized AirRestore Business Card BUSINESS CARD INFORMATION Dealer Name
SHIPPING INFORMATION Shipping Address
Web Address Your Company Phone Number Email Address Mailing Address
BILLING INFORMATION Name
(as it appears on card)
Credit Card Number Card Type
Choose Card Type
(Visa, MasterCard, Amex)
Expiration Date Security Code
ERIC CONVERSE Authorized AirRestore Dealer
www.AirRestoreUSA.com/eric
Billing Zipcode
Please fill out this form in its entirety. If there is a field that you would like to leave off of your card, simply write “BLANK” in the space. You can expect your cards to ship within 2-3 days of your order being placed. A total amount of $39.99 will be charged to your card. Shipping is included.
Company Name 763.555.1234
[email protected] 98765 Your Street NE YourTown, XX 55123
Sample of card design, not to scale
com.apple.idms.appleid.prd.444a5768324 d59664f534e42646e634a4776315858673d 3d
Digitally signed by com.apple.idms.appleid.prd.444a5768324d59664f534e42646e634a4776315858673d3d DN: cn=com.apple.idms.appleid.prd.444a5768324d59664f534e42646e634a4776315858673 d3d Date: 2013.04.15 15:20:43 -06'00'
