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    Phone Preference (subject to availability): Motorola i265
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    Cardholder First Name
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    Email Mail ($2 fee for US mail)
    Shipping Information Copy from Customer Info
    Shipping Method
    Standard ($7.50)
    Express ($15.00)
    Pick Up at Headquarters (FREE)
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    Special Instructions:
    By clicking submit, applicant agrees to the Terms and Conditions (click here to read) and understands that credit card will be authorized for the security deposit.

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    Created by: QuIC Solutions, Inc.