mbership Fee O Waive Membership Fee Permanently CARD/PIN ISSUANCE O Order New Card for O Charge Cardholder Replacement Card Fee of $ Sand Cud 0 Nonni Delivery • 7 • 1i; days (Check One): 0 Express Delivery • 2 days $10 O Saturday Delivery Add $10 O Charge Cardholder O Charge Financial Institution Festeard $20