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):
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Application
Form(s) needed by: (Date) |
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SHIPPING ADDRESS: |
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Name: |
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Company/Agency: |
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Complete Address: |
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City/State/Zip: |
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Telephone #:
Fax # |
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E-Mail Address: |
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COUNTRY |
QUANTITY |
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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