instructions - Access Securepak

1 From:
(Please Print) De: (Por Favor Imprima)
Name (Nombre)__________________________________________
Street Address (Dirección):__________________________________
City (Ciudad):____________________________________________
State (Estado): ____________ Zip (Código Postal):________________
Daytime Phone (Teléfono [en el día]): ( ______ )___________________
Email__________________________________________________
2 Ship to:
(Please Print)
Enviar a: (Por Favor Imprima)
Name (Nombre):__________________________________________
CDCR# (Número de Preso):__________________________________
Method:
5 Select Payment
❍
❍
Institutional Check
Money Order
Seleccione un Método de Pago:
MasterCard ❍
VISA ❍
(Make Institutional Checks & Money Orders Payable to ACCESS SECUREPAK®)
(Haga los Cheques y ordenes de dinero a Nombre de ACCESS SECUREPAK®)
Cardholder Name:___________________________________
(Imprima el Nombre de la Persona Dueña de la Tarjeta de Crédito)
(Please Print)
Cardholder’s Signature:_______________________________
(Firma de la Persona Dueña de la Tarjeta de Crédito)
Daytime Phone Number (Teléfono [en el día]): ( _____ )___________________
Credit Card Number (Número de la Tarjeta de Crédito)
Expiration Date: _______________
(Fecha de Vencimiento)
Dorm(Dormitorio)/Housing(Cuarto): ____ Inmate Box#(Celda):________
if applicable
As an added Security measure, please note the three-digit security
code on the back of your card.
Street Address (Dirección): __________________________________
Para agregar medida de seguridad, por favor inserte el código de
seguridad al reverso de su tarjeta.
State (Estado): _______________ Zip (Código Postal):_____________
3 Please circle appropriate quarter:
Por favor marque con un círculo el trimestre apropiado:
Qtr 1
Qtr 2
Qtr 3
Qtr 4
Jan. 1 - Mar. 31
April 1 - June 30
July 1 - Sept. 30
Oct. 1 - Dec. 31
Enero 1 - Marzo 31 Abril 1 - Junio 30 Julio 1 - Septiembre 30 Octubre 1 - Diciembre 31
(Sólo 1 paquete por trimestre)
Annual
One Package per year
(Un Paquete por año)
4 Substitutions: Substituciones
In the event of a back order, is it okay to substitute like items of equal or
greater value? En caso de no tener algun producto en el momento, esta bien que
remplacemos un producto parecido de igual o mayor precio?
Yes (Si) ❑
No
8 0 0 .5 4 6 .6
(No)
❑
We recommend choosing YES. If a selection is not made, Access
Securepak® will not substitute for items ordered that are out
of stock or that have been restricted by the state or institution.
Recomendamos escoger la opción SI. Si no esta marcada ninguna
opción, Access Securepak® no remplazará productos que no esten
disponibles ó restringidos por el Estado ó la Institución
Today’s Date:____________________
(Fecha de Hoy)
Last 3 digits of account
number panel
Los últimos 3 números
en el panel de atrás
MAIL ENTIRE AND
COMPLETED ORDER FORM
WITH PAYMENT TO:
ENVÍE TODA LA ORDEN
COMPLETA CON EL PAGO A:
Institution (Institución):_____________________________________
City (Ciudad):____________________________________________
DISCOVER ❍
(Cheque Institucional)
FORM
ORDER
California Quarterly Package Program / Programa De Paquete Trimestral
Access
Securepak®
P.O. Box 50028
Sparks, NV
89435-0028
*Prices include all applicable sales tax.*
Your family can also call 1-800-546-6283 to place a credit card order or
visit us at californiaqp.com
También puede llamar al 1-800-546-6283 para hacer un pedido con una tarjeta
de crédito ó visite nuestra página de internet en californiaqp.com
6 Weight Limit: Límite de Peso
In case the weight exceeds the state issued limit of 30 lbs. (480 oz.: 464 oz. product and 30 oz. packing material).
En caso que el peso sobrepase el límite promulgado por el estado de 30 libras. (480 onzas: 464 onzas de mercancia y 30
onzas para el material de empaquetado)
❍ Y es, please take off items to ensure package does not exceed (30 lbs.) weight limit.
Sí, por favor saque artículos del paquete para que no se pase del límite de peso de (30 libras).
❍ N o, do not take any items off order and return order form to sender. The order will not be
processed until weight limit is met.
No, no saque ningún artículo de la orden y devuelva la planilla para ordenar al remitente. La orden no sera procesada
hasta que el peso límite sea satisfecho.
283
339
ORDER
FORM
California Quarterly Package Program / Programa De Paquete Trimestral
For SecuRewards™ Customer Appreciation Promo, please enter item number(s) and description in the promo section below.
QTY.
ITEM#
DESCRIPTION/COLOR
SIZE
WEIGHT
TOTAL
WEIGHT
PRICE
TOTAL
PRICE
Promo Items— SecuRewards™ Premium members can choose two items.
Super Shopper Bonus Item — If you spend over $200.
Please list your 2nd shoe choice in the event your first shoe choice is not available. This applies to regular and Blow Out Special shoes.
Weight Total
(cannot exceed 464 oz. of product)
El peso total no puede sobrepasar 464 onzas.
❑ Yes, I have completed all six steps
on the front of the order form.
Si, he completado todos los seis pasos
en el frente del formulario.
*Please see reverse side for ordering instructions.
TOTAL PRICE (Total de la orden)
TOTAL PRICE of CDs (Total valor de CDs)
Sales Tax (Impuesto de venta)
Processing Fee (manejo y envío)
INCLUDED
$5.99
If placing an order for yourself, please add 10% IWF
Si va a hacer una orden para usted mismo, por favor agregue el 10% IWF
GRAND TOTAL (Total final)
c a li fo r n ia
340
q p .c o m
INSTRUCTIONS:
All songs on the Customized CD have a Song Identification Number, which is
listed in the Music Catalog or at californiaqp.com. If the song you want is not
listed in our Music Catalog, please feel free to list the artist and song
title, and we will check our music library consisting of 3 million songs.
SongsPrice
SongsPrice
1*. . . . . . . . . . . . . . . . . $6.84
11. . . . . . . . . . . . . . . . $20.34
2. . . . . . . . . . . . . . . . . . $8.19
12. . . . . . . . . . . . . . . . $21.69
3. . . . . . . . . . . . . . . . . . $9.54
13. . . . . . . . . . . . . . . . $23.04
4. . . . . . . . . . . . . . . . . $10.89
14. . . . . . . . . . . . . . . . $24.39
Order as many songs as you want up to 4,280 seconds (approximately 72
minutes). All songs are listed in seconds in the music catalog and on the website.
When ordering, please list songs in order of preference. To make ordering
easier, song length is included in the Music Catalog and on our website,
so you can squeeze as much music onto your CD as you want!
5. . . . . . . . . . . . . . . . . $12.24
15. . . . . . . . . . . . . . . . $25.74
6. . . . . . . . . . . . . . . . . $13.59
16. . . . . . . . . . . . . . . . $27.09
7. . . . . . . . . . . . . . . . . $14.94
17. . . . . . . . . . . . . . . . $28.44
8. . . . . . . . . . . . . . . . . $16.29
18. . . . . . . . . . . . . . . . $29.79
ONLY $1.35 PER SONG!
9. . . . . . . . . . . . . . . . . $17.64
19. . . . . . . . . . . . . . . . $31.14
10. . . . . . . . $18.99
20. . . . . . . . . . . . . . . . $32.49
NOW YOU CAN FILL THE ENTIRE CD!
A processing fee of $5.49 will be charged to each CD*.
FORM
ORDER
Customized CD Program
Due to the unique nature of our Customized CD Program, all customized CD sales are final
(unless defective). 1% of song downloads from music labels may contain problems. If you receive
a song that has downloaded incorrectly, please give your Customized CD to the property officer
with your concerns and your CD will be sent to Access Securepak. If we confirm that you received
a defective song, we will replace your entire CD at no charge. If the song was downloaded properly
and the song did not contain a defect, we will ship the CD back to you and you will be charged a
processing fee of $5.99. If your non-defective Custom CD is returned to our warehouse, we will hold
the Custom CD for 45 days. Please contact us to let us know where to send the Custom CD. There
will be a $5.99 processing fee to send the Custom CD to a new location. If you do not contact us
within 45 days, your Custom CD will be recycled.
8 0 0 .5 4 6 .6
283
*Each CD includes a processing fee of $5.49.
341
ORDER
FORM
Customized CD Program
SONG #
10-DIGIT SONG ID #
ARTIST
TITLE
SONG
DURATION
(SEC.)
1
2
NOTE:
3
4
5
6
7
8
CD 1
9
10
11
12
13
14
15
16
17
18
You MUST enclose
the ordering information
(sender’s name, ship to
and payment method) on
the Quarterly Package
Order Form to receive
your Custom CD.
19
20
TOTAL CD DURATION (not to exceed 4,280 seconds)
TOTAL PRICE of CD (see chart on previous page)
$
1
See chart on previous page
for cost per song.
2
3
4
5
6
7
TOTAL PRICE OF CDs
8
Total valore de CDs
CD 2
9
10
11
12
13
Sales Tax
Impuesto de venta
INCLUDED
GRAND TOTAL
Total final
14
15
16
17
18
19
20
TOTAL CD DURATION (not to exceed 4,280 seconds)
*CD wt. = 4 ounces
342
TOTAL PRICE of CD (see chart on previous page)
$
c a li fo r n ia
q p .c o m