AloSmart.com
398 MURFREESBORO PIKE
NASHVILLE, TN 37210 |
Phone: (615) 250-6393
(888) 808-7848
FAX: (615) 250-6394 |
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ORDER FORM
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| Card |
Price |
Quantity |
Total |
| [ ] ABSOLUTE WORLD | $5.00 | ______ | $________ |
| [ ] ABSOLUTE WORLD | $6.00 | ______ | $________ |
| [ ] ABSOLUTE WORLD | $10.00 | ______ | $________ |
| [ ] ABSOLUTE WORLD | $20.00 | ______ | $________ |
| [ ] AFRICA SAFARI | $2.00 | ______ | $________ |
| [ ] AFRICA SAFARI | $5.00 | ______ | $________ |
| [ ] AFRICA SAFARI | $10.00 | ______ | $________ |
| [ ] Alo Cellular | $4.00 | ______ | $________ |
| [ ] ALO Express | $5.00 | ______ | $________ |
| [ ] ALO Express | $10.00 | ______ | $________ |
| [ ] ALO Express | $20.00 | ______ | $________ |
| [ ] ALO QUEEN | $2.00 | ______ | $________ |
| [ ] ALO QUEEN | $5.00 | ______ | $________ |
| [ ] ALO QUEEN | $10.00 | ______ | $________ |
| [ ] ALO WORLD | $2.00 | ______ | $________ |
| [ ] ALO WORLD | $5.00 | ______ | $________ |
| [ ] ALO WORLD | $10.00 | ______ | $________ |
| [ ] ANYWHERE | $5.00 | ______ | $________ |
| [ ] ANYWHERE | $10.00 | ______ | $________ |
| [ ] ANYWHERE | $20.00 | ______ | $________ |
| [ ] ASIAN UNION | $2.00 | ______ | $________ |
| [ ] ASIAN UNION | $4.00 | ______ | $________ |
| [ ] ASIAN UNION | $5.00 | ______ | $________ |
| [ ] ASIAN UNION | $10.00 | ______ | $________ |
| [ ] BARGAIN TALK | $2.00 | ______ | $________ |
| [ ] BARGAIN TALK | $5.00 | ______ | $________ |
| [ ] BLUE DIAMOND | $2.00 | ______ | $________ |
| [ ] BLUE DIAMOND | $5.00 | ______ | $________ |
| [ ] CALL ANYTIME | $5.00 | ______ | $________ |
| [ ] CALL ANYTIME | $10.00 | ______ | $________ |
| [ ] CALL ANYTIME | $20.00 | ______ | $________ |
| [ ] CALL NATION | $5.00 | ______ | $________ |
| [ ] CALL NATION | $10.00 | ______ | $________ |
| [ ] CITY EXPRESS | $20.00 | ______ | $________ |
| [ ] COOL CARD | $2.00 | ______ | $________ |
| [ ] COOL CARD | $5.00 | ______ | $________ |
| [ ] COOL CARD | $10.00 | ______ | $________ |
| [ ] CRYSTAL CLEAR | $2.00 | ______ | $________ |
| [ ] CRYSTAL CLEAR | $5.00 | ______ | $________ |
| [ ] CRYSTAL CLEAR | $10.00 | ______ | $________ |
| [ ] DESERT EXPRESS | $2.00 | ______ | $________ |
| [ ] DESERT EXPRESS | $5.00 | ______ | $________ |
| [ ] DESERT EXPRESS | $8.00 | ______ | $________ |
| [ ] DESERT EXPRESS | $10.00 | ______ | $________ |
| [ ] DESTINY | $2.00 | ______ | $________ |
| [ ] DESTINY | $5.00 | ______ | $________ |
| [ ] DESTINY | $10.00 | ______ | $________ |
| [ ] DIAL N SMILE | $2.00 | ______ | $________ |
| [ ] DIAL N SMILE | $5.00 | ______ | $________ |
| [ ] DIRECT TALK | $2.00 | ______ | $________ |
| [ ] DIRECT TALK | $5.00 | ______ | $________ |
| [ ] DREAMS | $2.00 | ______ | $________ |
| [ ] DREAMS | $5.00 | ______ | $________ |
| [ ] DREAMS | $7.00 | ______ | $________ |
| [ ] DREAMS | $10.00 | ______ | $________ |
| [ ] EAGLE | $2.00 | ______ | $________ |
| [ ] EAGLE | $5.00 | ______ | $________ |
| [ ] EASY DIAL | $5.00 | ______ | $________ |
| [ ] EASY DIAL | $8.00 | ______ | $________ |
| [ ] EASY DIAL | $10.00 | ______ | $________ |
| [ ] EASY DIAL | $20.00 | ______ | $________ |
| [ ] Extra Talk | $6.00 | ______ | $________ |
| [ ] Extra Talk | $12.00 | ______ | $________ |
| [ ] Extra Talk | $25.00 | ______ | $________ |
| [ ] FAR EAST(100%CLEAN) | $8.00 | ______ | $________ |
| [ ] FIRST CLASS | $2.00 | ______ | $________ |
| [ ] FIRST CLASS | $5.00 | ______ | $________ |
| [ ] FREEDOM CALL | $5.00 | ______ | $________ |
| [ ] FREEDOM CALL | $10.00 | ______ | $________ |
| [ ] FREEDOM CALL | $20.00 | ______ | $________ |
| [ ] GLOBAL CONNECT | $5.00 | ______ | $________ |
| [ ] GLOBAL CONNECT | $10.00 | ______ | $________ |
| [ ] GLOBAL CONNECT | $20.00 | ______ | $________ |
| [ ] GOAL | $20.00 | ______ | $________ |
| [ ] HAPPINESS | $2.00 | ______ | $________ |
| [ ] HAPPINESS | $5.00 | ______ | $________ |
| [ ] HOLIDAY | $2.00 | ______ | $________ |
| [ ] HOLIDAY | $5.00 | ______ | $________ |
| [ ] HOLIDAY | $7.00 | ______ | $________ |
| [ ] HOLIDAY | $10.00 | ______ | $________ |
| [ ] International Card | $2.00 | ______ | $________ |
| [ ] International Card | $5.00 | ______ | $________ |
| [ ] MIDDLE EAST | $2.00 | ______ | $________ |
| [ ] MIDDLE EAST | $5.00 | ______ | $________ |
| [ ] MyQuest | $2.00 | ______ | $________ |
| [ ] MyQuest | $5.00 | ______ | $________ |
| [ ] ONE MINUTE | $6.00 | ______ | $________ |
| [ ] ONE MINUTE | $12.00 | ______ | $________ |
| [ ] ONE MINUTE | $25.00 | ______ | $________ |
| [ ] ONLY ONE | $2.00 | ______ | $________ |
| [ ] ONLY ONE | $5.00 | ______ | $________ |
| [ ] ONLY ONE | $10.00 | ______ | $________ |
| [ ] PASSPORT | $2.00 | ______ | $________ |
| [ ] PASSPORT | $5.00 | ______ | $________ |
| [ ] PASSPORT | $10.00 | ______ | $________ |
| [ ] PINLESS PLATINUM | $10.00 | ______ | $________ |
| [ ] PINLESS PLATINUM | $25.00 | ______ | $________ |
| [ ] PINLESS Platinum REFILL | $25.00 | ______ | $________ |
| [ ] PINLESS Platinum REFILL | $50.00 | ______ | $________ |
| [ ] PINLESS Platinum REFILL | $100.00 | ______ | $________ |
| [ ] PINLESS Rechargeable | $25.00 | ______ | $________ |
| [ ] PINLESS Rechargeable | $50.00 | ______ | $________ |
| [ ] PINLESS Rechargeable | $100.00 | ______ | $________ |
| [ ] POWER | $2.00 | ______ | $________ |
| [ ] POWER | $5.00 | ______ | $________ |
| [ ] PYRAMID | $2.00 | ______ | $________ |
| [ ] PYRAMID | $5.00 | ______ | $________ |
| [ ] QUALITY CARD | $5.00 | ______ | $________ |
| [ ] QUALITY CARD | $10.00 | ______ | $________ |
| [ ] QUALITY CARD | $20.00 | ______ | $________ |
| [ ] REAL TALK | $2.00 | ______ | $________ |
| [ ] REAL TALK | $5.00 | ______ | $________ |
| [ ] REAL TALK | $10.00 | ______ | $________ |
| [ ] Refill AAAAAAAAA | $25.00 | ______ | $________ |
| [ ] Refill AAAAAAAAA | $50.00 | ______ | $________ |
| [ ] Refill AAAAAAAAA | $100.00 | ______ | $________ |
| [ ] Refill AAAAAAAAA | $200.00 | ______ | $________ |
| [ ] ROYAL ASIA | $5.00 | ______ | $________ |
| [ ] ROYAL ASIA | $10.00 | ______ | $________ |
| [ ] ROYAL ASIA | $20.00 | ______ | $________ |
| [ ] SMART CHOICE(100%CLEAN) | $3.50 | ______ | $________ |
| [ ] SMART CHOICE(100%CLEAN) | $7.00 | ______ | $________ |
| [ ] SUPREME | $2.00 | ______ | $________ |
| [ ] SUPREME | $5.00 | ______ | $________ |
| [ ] SYRIAN LINK | $1.00 | ______ | $________ |
| [ ] SYRIAN LINK | $2.00 | ______ | $________ |
| [ ] SYRIAN LINK | $5.00 | ______ | $________ |
| [ ] THE ONLY CARD | $5.00 | ______ | $________ |
| [ ] THE ONLY CARD | $10.00 | ______ | $________ |
| [ ] TIME SQUARE | $2.00 | ______ | $________ |
| [ ] TIME SQUARE | $3.00 | ______ | $________ |
| [ ] TIME SQUARE | $5.00 | ______ | $________ |
| [ ] TIME SQUARE | $10.00 | ______ | $________ |
| [ ] UNLIMITED | $2.00 | ______ | $________ |
| [ ] UNLIMITED | $5.00 | ______ | $________ |
| [ ] UNLIMITED | $10.00 | ______ | $________ |
| [ ] World Connect | $5.00 | ______ | $________ |
| [ ] World Connect | $10.00 | ______ | $________ |
| [ ] World Connect | $20.00 | ______ | $________ |
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| Total: | $________ |
| DELIVERY OPTIONS:
[ ] E-Mail PINs (FREE)
[ ] Fax PINs (FREE)
[ ] Mail the cards ($2.00) | $________ |
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Please provide the following information about yourself:
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| Last Name |
_________________________ |
First Name |
_________________________ |
| Title |
_________________________ |
Company |
_________________________ |
| Address (billing) |
________________________________________________________________ |
| City |
_________________________ |
State/Province |
_______ |
| Zip/Postal code |
_________________________ |
Country |
_________________________ |
| Evening Phone |
(_____)_______________ |
Day Phone |
(_____)_______________ |
| FAX |
(_____)_______________ |
E-mail |
_________________________ |
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Payment Information:
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| [ ] Check/Money Order Included |
[ ] Credit Card |
| If paying by credit card:
Credit Card Type: |
[ ] VISA [ ] MasterCard |
| Number |
__________________________________________ |
| Expiration Date |
____/________(mm/yyyy) |
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