請列印後再填寫資料及簽名

Credit Card Order Form 比特族信用卡專用訂購單

卡別: □  Visa      □ Master      □ Amex

Card Number  卡號:                                                        

Card Verification Value  安全碼:                            (this is the 3-4 digit number found on the back of most major credit cards)

Expiration Date  有效期限:              月(M)                年(Y)

Name on Card卡上姓名:                                                                                   

Id #身份證字號：                                                                                                (Passport #)

Amount 訂購總金額新臺幣:                                          元(T.W.D.)

Signature卡上簽名:                                                                                                 

Billing Address 帳單地址:                                                                                                   

Phone #帳單電話:                                                   Fax #傳真:                                         

E-Mail:                                                                                    

請傳真、E-mail:99@puppykitty.com或寄到:台北市信義區松德路159號9樓之一