STAMP N PLUS SCRAP N

 PREFERRED CUSTOMER APPLICATION

Please fill out clearly and completely

Date:                             

Name:                                                                                     

Address:                                                                                 

City:                                                                                       

State:                                                 Zip:                               

Daytime Phone:                                                  Evening Phone:                                               

Email:                                                                                     

Cash:                                    Check:                                          

Credit Card:                                                                              (Visa, Master Card, Discover)

Credit Card No.:                                                                        Expiration:  

Name on Card:                                                                   

I understand that signing up for the Stamp N Plus Scrap N Preferred Customer Program, that I have no obligation to purchase any products.  I further understand that Stamp n Plus Scrap N will send me mailings with updates on products and stamping or scrapbooking related products and techniques.  This membership is annual and expires one year from the date I submit this application.  Member benefits may change from time to time.  The cost to be a member is $19.95 a year or you can pay a one-time membership fee of $99.95 for a lifetime, which if approved entitles me to all benefits available to members.

Buyers Club Members are nontransferable and cannot be canceled for a refund.  Merchandise purchases are for members only and cannot be used by non-members.

I understand and agree to all terms and conditions of Membership Savings and Bonus features.

Signature_________________________________             Date_____________

Mail or fax this application along with your payment to:

Stamp N Plus Scrap N

P. O. Box 47 Chippewa Falls, WI 54729

For Office use only