Plastilam Electro-Cards Order Form                              Home
Please fill in the order form below.
* denotes required fields for the form

Company

Contact *

E-Mail *
Phone *
 		Fax *
Address *
City *

State
 		Zip

Country *
Payment Information:
Credit Card Type (Amex/Visa/MC)

Credit Card Number

Expiration Date
Special Requests: Questions or Additional Info
Gift Card Section:
Qty
Generic package -300 cards and Software $199.00
VeriFone Terminals $450.00
Card Carriers:
100 pcs. @ .99¢ each
500 pcs. @ .79¢ each
1000 pcs. @ .55¢ each
2500 pcs. @ .49¢ each
5000 pcs. @ .45¢ each