| E-MARKETING ORDER PAGE | ||||||||||||||||||||||||
| FAXCHECK | ||||||||||||||||||||||||
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TO ORDER BY FAXCHECK: COPY AND COMPLETE THIS FORM. (US Banks only please) Package You Are Ordering: $______________ Name & address as it appears on the check: ____________________________________ ____________________________________ ____________________________________ Bank Phone Number: ______________ Check number: _______________________ Amount of Check: ______________________ Branch Number ( this number is usually located under check number -- Example: 15-7060/1234) ____________________________________ Bank name & address: ____________________________________ ____________________________________ ____________________________________ Bank routing number (9-digit number found bottom left before account number): ____________________________________ Account number: ____________________________________ Email address: ____________________________________ Signature ____________________________________ COPY THIS FORM AND FAX TO: 603-994-1618 | |||||||||||||||||||||||
| EMAIL CHECK | ||||||||||||||||||||||||
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TO ORDER BY EMAIL CHECK: COPY AND COMPLETE THIS FORM. Electronic Check Information (checks from U.S. banks only please): Package You Are Ordering: ______________ Name & address as it appears on the check: ____________________________________ ____________________________________ ____________________________________ Bank Phone Number: ______________ Check number: _______________________ Amount of Check: ______________________ Branch Number ( this number is usually located under check number -- Example: 15-7060/1234) ____________________________________ Bank name & address: ____________________________________ ____________________________________ ____________________________________ Bank routing number (9-digit number found bottom left before account number): ____________________________________ Account number: ____________________________________ Email address: ____________________________________ Signature ____________________________________ COPY THIS FORM AND EMAIL TO: [email protected] | |||||||||||||||||||||||
| SECURE ONLINE PROCESSING | ||||||||||||||||||||||||
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TO ORDER BY SECURE ONLINE CHECK PROCESSING | click here to pay by instant online check
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