Insurance Georgia
Agent Payment Form

All agents must setup credit card or bank draft payments for Phone and Web Service.
Just click the link below and fill out the forms to setup your payments.


Payment for 5000 Business Cards at $.027 Each

5000 Cards / 2 Sides Full Color   $134.61

                Layout / Logo Upload- $34.94

                                     Shipping $14.50

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                         Total         -   $184.43

You will be Emailed a Proof of your Card Before Printing.
Please check your Name on Your Proof Card as there will be no refund after the proof has been Sent to the Printer.

Make sure to fill in the order form on the next page as you would
 like your information to appear on your business card.

Enter Your Name