Sales Office: —Please choose an option—ACE-BPOCITY-BPO Deal Status: —Please choose an option—SALEPendingCall BackHang UpDisconnect Sales Agent: Sales Date: Account#: CUSTOMER INFO A) Which of the following Gift Select? —Please choose an option—4 NIGHT TRIP TO LAS VEGAS7 NIGHTS RESORT GETAWAY FAMILY OF FOUR5 DAYS LUXURY CRUISE B) Bonus Gift Select? —Please choose an option—2 ALL-INCLUSIVE GETAWAY2 NIGHT ALL-INCLUSIVE RESORT GETAWAY$300 RESTAURANT CASHPREMIUM QUALITY TRUE WIRELESS EARBUDS C) Customer Understand they Have to Pay Activation FEE $299.95? —Please choose an option—YesNo Your message (optional)