Friendship Discount Application

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="34b785a3.jpg"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>Western Trade Exchange</B></FONT><B>    </B><B> |     </B><A HREF="index.htm" TARGET="_top" TITLE="Western Trade Exchange"><U><B>home</B></U></A></div> <div> <B>Friendship Discount Application</B></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" background="34cd2b03.jpg"> <div> Back to:<A HREF="id20.htm" TARGET="_top" TITLE=" Friendship Discounts"><U> "Friendship Discounts"</U></A></div> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Friendship Discount Application</I></div> <bR> <div> Please print and mail this form to WTE:</div> <bR> <div> Please send a Friendship Discount purchase order for the following business selected from the Goods and Services listings:</div> <bR> <div> Business Name:___________________________</div> <div> Address:________________________________</div> <div> We request a face value of $_________ on this purchase order.</div> <bR> <div> Please charge our MC______    Visa______ card 90% of the above face value.</div> <bR> <div>  My Name:______________________________</div> <div> Card holder name:________________________</div> <div> Card holder signature:_____________________</div> <div> Card number:___________________________</div> <div> Expiration date:_________________</div> <bR> <div> Street:_________________________________</div> <div> City:__________________    State:__________</div> <div> Telephone:_____________________________</div> <div> Fax (if any):____________________________</div> <bR> <div> Please mail or fax this application to WTE at the fax number as shown in <A HREF="id21.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>.</div> </td> </tr></table></body>