paymentapplication

OPTION #2
Bi-Weekly
Duration: Up to 5 Months
{10 Equal Payments with-in Duration}
Minimum Purchase: $300.00
20% Deposit Required

OPTION #1
Monthly
Duration: Up to 5 Months
{5 Equal Payments with-in Duration}
Minimum Purchase: $300.00
20% Deposit Required

Date: ______________

**Print Page and Complete

Name on Card Account: _______________________
Address Street _______________________________
Apt.    _____
City    _________________State _____ Zip_______
E-Mail: ________________
Phone: _______________ Fax: ________________
Card Type: Visa   M/C A/E   Card # __________________________ Expires: ________
                          Signature required: ____________________________
Quantities Needed
- Pears ______   Color(s) _______________________________________________
-Tulle ______   Color(s) ________________________________________________
- Bow ______   Color(s) ________________________________________________
- Gift Boxes ____    (White Only)
- Personalized Leaves _____
Leaf Quote: ________________________________________________________

Shipping Address
Name: ___________________________________
Street _______________________________Apt.    _____
City    __________________________ State _____    Zip __________

Desired Beginning Scheduled Date(s) for Payments
(Example: Friday, March 29, 2002 to Friday, August 30, 2002 - 5 Months)

*____________________________________________________________________________*

Mail to: PTCC Inc., 9623 Denbolme Street, Huntersville, NC 28078
***Fax Application to: 704-947-3115***
Questions? Call 1-704-577-9228 or

**By the signature of the Applicant agrees to Terms and Conditions below. No Products are shipped until final payment has been received. If any automatic scheduled payment is rejected or declined, the cardholder will be contacted via E-mail or telephone. The Applicant has up to 5 business days to make the payment due. If Applicant fails to provide past due payment within 5 business days, PTCC reserves the right to desolve PSA. The Applicant forfits any/all funds previously paid to PTCC Inc.