ORIGINAL APPLICATION ORDER FORM

 

 

 

This Application Order Form has been provided for your convenience in requesting original applications. 

We will send you application forms by U.S. Postal Service FREE of Charge.

 

 

Please fax this Application Order Form to 530-579-3315.  We will fax or e-mail you a shipment confirmation.  If you have not received a shipment confirmation within 24 hours, please call us at

1-866-886-VISA (8472).

 

 

Shipping address to which application(s) should be sent (Note: a P.O. Box cannot be used for expedited shipping):

 

Application Form(s) needed by: (Date)

SHIPPING ADDRESS:

 

 

Name:

 

 

Company/Agency:

 

 

Complete Address:

 

 

City/State/Zip:

 

 

Telephone #:                                                                      Fax #

 

 

E-Mail Address:

 

 

COUNTRY

QUANTITY

 

 

 

 

 

 

 

 If you wish to receive application forms in an expedite manner (like Federal Express, UPS, Airborne,

DHL), please provide us with your Account Number.  Please Circle One:

 

FedEx       Airborne         UPS    DHL                Account #: _____________________________

 

 

 If you do not have an Account Number with any courier service, we ask you to pay by credit card.

 

I, _______________________________________, hereby authorize Travel the World Visas to charge $18.00 per eight ounces per continental U.S. address for expedite shipping/handling to my Visa / Master Card (Circle One).

 

Credit Card #: ____________________________ Expiration Date: _______________________

 

Signature: ___________________________________________

 

 

Travel the World Visas  . . . linking you with your global destination!

717 Dartmouth Avenue

Silver Spring, MD  20910

www.world-visa.com                                                         e-mail: info@world-visa.com

Telephone: 301-495-7700                                                Fax:  530-579-3315