American Express Travelers Cheque Pre-Order Form


TRAVELERS CHEQUES
Available In The Following Express Pac Denominations:

$200 (Ten $20 Cheques)

$150 (Three $50 Cheques)
$250 (Five $50 Cheques)
$500 (Ten $50 Cheques)

$300 (Three $100 Cheques)
$500 (Five $100 Cheques)
$1,000 (Ten $100 Cheques)
FOREIGN CURRENCY TRAVELERS CHEQUES
Available In The Following Currencies
And Must Be Special Ordered

EURO • AUSTRALIAN DOLLAR
SOUTH AFRICAN RAND
BRITISH POUND STERLING
CANADIAN DOLLAR
SWISS FRANC • JAPANESE YEN
SAUDI RIYAL
CHEQUES FOR TWO ®
Available In The Following Express Pac Denominations:

$200 (Ten $20 Cheques)

$150 (Three $50 Cheques)
$250 (Five $50 Cheques)

$500 (Five $100 Cheques)


    1. PERSONAL INFORMATION
Name:   
   
eMail Address:   
   
Address Line 1:   
   
Address Line 2:   
   
City:   
   
State:   
       Zip Code:
Daytime Contact Telephone:   
(With Area Code)   
   
    2. ORDER INFORMATION
American Express:   
TRAVELERS CHEQUES   
US Dollar Amount   
   $
Type:   
     Standard Cheques     Cheques For Two ®
Express Pac:   
Denominations   

See Express Pac Denomination Breakdowns    
At The Top Of The Page.   

   $20's    $50's    $100's

   (Other Combination)
   

Currency:   
   
Date Needed By:   
   
    3. PAYMENT INFORMATION
Please Use My Credit Card On File:   
    American Express MasterCard
    VISA Discover
Process Payment By Phone:   
    I'll Call My Agent Have My Agent Call Me
Remarks Or Comments   
   
    THANK YOU!





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http://landfalltravel.com