Complete the information you want on your card and mail this form with
your payment to the address listed below.

(a) This section will be printed in black
Company Name:���
Street Address:���
City, State ZIP + 4:��
Phone #:���
Fax #:

(b) Choose one color for the both of these: _____________________
Your Name:���
Your Title:���

(c) Choose a color: ________________________
Email Address:

(d) Choose a picture or send one of your own
picture number:
right or left side of card:

(e)� Choose your :
font (arial, times new roman,� etc.)� default font=courier: __________________
style (regular, bold, italic) default style=regular:� __________________________

(f)� Number of cards ordered: ________________
������� Prices:� 100 cards for $15.00 or 200 cards for $25.00 (U.S. currency)
*****Add a shipping fee of $3.00 to your order*****

Shipping information (if different from above):
Your Name:
Address:
City, State� Zip +4:
*EMail address:
*You will be notified when your order has been shipped.

Kindly send a money order** with this completed form to:
L. D. Benson
250 N Broadway
Yonkers, NY� 10701-2636

**NOTE:� Personal checks will be accepted and your order will be processed once
�������� the check clears.�

�������������������������� Thank You for your Business