VIP Card Purchase 4.0

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Best of Newburyport VIP Card Purchase

IMPORTANT ORDER FORM INSTRUCTIONS:

1. Purchase one card for $25 or two for $40 and $10 of your purchase will be donated to a local nonprofit partner.

2. Select Digital VIP Card or Physical VIP Card for each card purchased.

3. If purchasing cards for others and you don't know their email address, leave the field blank. DO NOT enter your email address as a place holder.

4. Email VIPcard@Newburyport.com with questions.

Card Quantity & Cost

Total Quantity of Cards ($25 for 1st card & $15 for additional card)*

1 2

Total Cost* $

Is one card is for you?*

Yes No

Quantity (for stripe)

gift

Purchaser Card

Do you want a Digital VIP Card login for the Newburyport App or a Physical VIP Card sent by regular mail?

Digital VIP Card Login Physical VIP Card

Name

First Name

Last Name

Additional Card Recipient

Does this person want to receive a Digital VIP Card login for the Newburyport App or a Physical VIP Card sent by regular mail? (1)*

Digital VIP Card Login Physical VIP Card

If ordering cards for others and you don't know their email address, leave the field blank. DO NOT enter your email address as a place holder.

If giving a VIP Card as a gift and you don't want the recipient to know as soon as your order is submitted, leave the card recipient email field blank and write the email address in the order comments with a date and time that you would like us to register the card.

Name (1)

First Name

Last Name

Email (1)

Additional Card Recipient

Does this person want to receive a Digital VIP Card login for the Newburyport App or a Physical VIP Card sent by regular mail? (2)

Digital VIP Card Login Physical VIP Card

If ordering cards for others and you don't know their email address, leave the field blank. DO NOT enter your email address as a place holder.

Name (2)

First Name

Last Name

Email (2)

Purchaser Credit Card Information

Purchaser Name*

First Name

Last Name

Purchaser Email*

Phone*

Credit Card*

Billing Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Billing & Shipping Address Are The Same

Yes

All physical VIP cards are mailed to purchaser address. If purchasing cards for others and you would like us to ship directly to them, please indicate in the comments field.

Ship To Name

First Name

Last Name

Shipping Address

Address Line 1

Address Line 2

City

State

ZIP Code

Comments

Best of Newburyport VIP Card Purchase

Card Quantity & Cost

Purchaser Card

Additional Card Recipient

Additional Card Recipient

Purchaser Credit Card Information

Choose Which Local Nonprofit Partner You Would Like To Support. They Will Receive $10 Of Your Purchase.