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