EZ-Order Form

Solutions Inc.

E Z - O R D E R
F O R M

To send in a EZ-Order to AGI, Please fill out the form below
and click on the Submit Button at the bottom of the page.
Any Questions Call Toll Free 1-888-987-8425

PERSONAL INFORMATION:

Note: There is NO CREDIT CARD Information/Numbers transferred by this form.
They are only sent by secure encrypted email.
We DO NOT store any Credit Card Numbers.
If you like, you can call your order in using our toll-free Number 1-888-987-8425

Please provide the following information:

Required Fields *

Company *

Name *

Street Address *

Address (cont.)

City *

State/Province *

Zip/Postal Code *

E-mail *

P.O. Number

Phone Phone format (999) 999-9999          Ext.
*

FAX

PLEASE SHIP TO:

Company *

Name *

Street Address *

Address (cont.)

City *

State/Province *

Zip/Postal Code *

ORDER INFORMATION:

Quantity: * Item *

No. of Colors:      Colors

Please check if Item numbers, and indicate Start and Stop number.

            Price    *

Prep./Setup:   $19.95 (Printed Items Only)

FREE   SHIPPING

Please Enter Copy Information

If you have a Art file or Logo, click here to Upload.


CREDIT CARD INFORMATION:

Please Bill to Master Card     Visa     Disc.       Amex.*

Cardholder's Name on Credit Card *

Credit Card Mailing Address *

Credit Card Number * (Expiration 4 digit)   * (Exp.) 06/05

Credit Card CVC Number

            *   Where is my

Please enter the 5 digit code in the box below,
then click on the Submit Form Button.
THIS IS USED TO STOP SPAM BOTS FROM AUTO FILLING THIS FORM!

Security Code: *

Please Click only once, if you are sending a large file it might
take several minutes to complete, depending on connection.
Page will change when UPLOAD is complete.