Name:             Card4Life, Inc. does not sell directly, but rather

Address:        through a network of distributors.  When you

City:              send in this form, it will be immediately sent to

State:       Zip Code:       the appropriate distributor for action.

Phone:       

E-mail:                              

Comments:

At Card4Life we value your privacy and security.  We do not give out information to anyone outside of Card4Life.  We will not sell or otherwise provide your e-mail address or any of the information you provide.  In the same manner we will not send you spam e-mails.