Vinyl Cover included in every check order One box of checks costs $22. Eleven dollars of your purchase goes to St. Jude Children’s Research Hospital ® and is tax deductible. Each order includes 30 deposit tickets per box and a St. Jude vinyl logo checkbook cover. St. Jude checks meet or exceed all industry standards and are guaranteed to process correctly at your financial institution. The checks are printed on quality security paper and contain other security features to deter fraud. ORDER FORM Information to appear on check: Name _________________________________________________ Address________________________________________________ City ________________________ State______ ZIP_____________ Phone (Hm) ____________________________________________ Phone (Wk) E-mail_________________________________________________ Starting Check # Check Design & Quantity: 1 Box 2 Boxes 4 Boxes $22 $44 $88 Children’s Art Singles (150/box) Duplicates (150/box) Logo Singles (150/box) Duplicates (150/box) Price subject to change without notice. Total Payment $ ____________________________ Mail the following items to the address below: 1. Completed order form. 2. Voided check from existing checks; note changes. 3. Deposit slip from existing checks. 4. Payment check or completed electronic payment information requested above. Please allow 14 business days from receipt of order for delivery of checks. Mail orders may be sent to: 2435 Goodwin Lane • New Braunfels, TX 78135 Customer Service 866-622-7136 • Fax 800-822-0005 SCHCBOXD08 St. Jude does not endorse products or services. ©2010 ALSAC/St. Jude Children’s Research Hospital (02959) Children’s Art Logo Payment Options: Enclosed Personal Check (made payable to “St. Jude Checks”) Direct Debit Checking Account _____________________________ Signature Required Credit/Debit Card _______________________ Account Number _________________ Signature Required Organization/Company (affiliated with St. Jude) _____________________ Chapter/Terminal _________________________________________ Vinyl Cover included in every check order Exp. Date ____________________________________________ Label Design & Quantity: 1 Set (144) 2 Sets (288) $12 $24 Children’s Art Logo