Fillable Subway Volume Card & Fundraiser Order Form printable pdf download

VOLUME CARD & FUNDRAISER ORDER FORM

Please fax your completed form to VPS at 305.670.9586 | DO NOT E-MAIL THIS FORM

Purchaser Information

Shipping Information

New Client

Reorder

Same as Customer Information

Name: ____________________________________________________

Order Date: _____ / _____ / ______ PO#: _______________________

Company Name: ___________________________________________

Name: ____________________________________________________

Address: __________________________________________________

Company Name: ___________________________________________

Address: __________________________________________________

City: ___________________ State: _____________ Zip: ____________

Phone: __________________ E-Mail: ___________________________

Address: __________________________________________________

City: ___________________ State: _____________ Zip: ____________

Payment Information

Phone: __________________ E-Mail: ___________________________

Credit Card Payment*

* (Limit $5,000. For orders over this amount please use another payment method.)

Federal Tax ID/BN#

_______________________________

(required for fundraisers):

VISA

MASTERCARD

AMEX

DISCOVER

Referring SUBWAY Store # ____________

Name on Card: _____________________________________________

Ordering Information

Address: __________________________________________________

Min. Order: 10 Cards | Min. Card Load: $5 | Min. Total Order: $250 | Max. Card Load: $100

Address: __________________________________________________

BULK ORDER DISCOUNT - Save 2% on any order of $5,000 or more.*

City: ___________________ State: _____________ Zip: ____________

FUNDRAISER BULK DISCOUNT - Save 6% on any order of $500 or more.*

Phone: __________________ E-Mail: ___________________________

Must provide a valid 501(c)(3) Tax Exempt #________________

Card #: ____________________________________________________

* Not applicable on purchases made with a credit card

Expiration #: _____ / ______

Security #: _____________

• When ordering multiple currencies, please submit separate order forms for each currency.

Authorized Signature: _______________________________________

Cards will be loaded with either U.S. or Canadian Dollars however, cards can be used in either country.

The Point-of-Sale system will automatically convert currency at the time of transaction based on established

ACH

AVAILABLE ONLY IN THE U.S.

exchange rates. **Bilingual Cards are intended for use in Canada.

* (Fax to 305.670.9586)

Specify Funds To Be Loaded

$US

$CANADA

Account #: _____________________ ABA#: _____________________

Name on Account: __________________________________________

United States (English)

Card

Card Load Denom.

Line Total

Quantity

Canada (English/French)

($5 - $100)

(Quantity x Denom.)

Authorized Signature: _______________________________________

I hearby authorize VPS LLC to initiate a debit transaction for the order total amount from

the account speci ed above.

FAF

Program Description: ________________________________________

Pack

Line Total

Market #: __________________ Program Timing: _________________

Envelope Item Description

Price Per Pack of 50

Quantity

(Quantity x Price)

COMPANY CHECK or MONEY ORDER

U.S. Green Bow Envelope

$4.00

Make Checks Payable to: Value Pay Services

Canada Red Bow Envelope

$4.00

Mail Order Form with payment to:

SELECT SHIPPING OPTION BELOW

SUBWAY CARD PROGRAM

Ground Delivery (1-6 Days)

FREE

Value Pay Services LLC | ATTN: Corporate Sales

9200 S. Dadeland Blvd. Suite 705 | Miami, FL 33156

Under 250 Cards

$60.00

Next Business Day

Orders must be received by 11:00 am Eastern

* Orders paid by check will not be processed until funds have cleared the bank (7-10 days)

251 - 2500 Cards

$150.00

for same day shipping. Applies to shipping only within

All orders are NOT processed until payment is con rmed. All bulk order Card sales are nal. No return and no refunds. Cards

continental United States

are shipped inactive as a safeguard against unauthorized use in the event cards are lost or stolen. Buyer is required to submit

2501 - 5000 Cards

$250.00

an activation request form to VPS to con rm delivery of order so that cards can be activated prior to use. Card activation takes

24-48 business hours from VPS’ receipt of your activation form. Card balances do not expire or decline with non-use nor are

Card Total

Shipping Information

there any fees or service charges associated with dormancy. SUBWAY® Cards can be used in the United States, Canada, Puerto

Allow 2-3 days for order processing prior to shipping.

Rico, Guam and Saipan at this time.

Shipping is available to one address only.

Less Discount

Orders are not processed until payment is con rmed.

When, where and how will these cards be used or distributed and will there

*Overnight orders must be receieved no later than 11:00 am

Order Total

Eastern for order to be processed for delivery.

be any promotional or marketing materials created?

Authorized Signature

Signature _____________________________ Title ________________

Company __________________________ Date ____ / ____ / _______

Any materials created by you which feature the SUBWAY® logos, Cards, Menu Items, or other proprietary images

Terms & Conditions

must be submitted to VPS for approval prior to their use or distribution. Submit to:

By signing the above you agree to purchase the cards specified in this order. SUBWAY® Cards are issued by Value Pay Services

LLC and may only be used for purchases at participating SUBWAY® restaurants. Unless the Card is registered online at

Internal VPS use only

, remaining balances on lost, stolen or damaged Cards cannot be replaced or refunded.

501(c)(3) Tax Exempt # Veri cation

Questions? Please contact Value Pay Services (VPS) at 786-270-1273

IPC: _________________________

Subway Volume Card & Fundraiser Order Form

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