Subway Certificate Format Form PDF Details

The Subway Certificate Format form serves as a vital administrative tool for both individuals and organizations looking to purchase Subway cards in bulk, whether for volume purchases or fundraising activities. It meticulously outlines the necessary purchaser information, including the option for new clients or reorders, along with detailed ordering and shipping information. This form caters to a variety of needs by accommodating orders for cards that can be loaded with specified amounts between $5 and $100, offering significant discounts for bulk purchases, and ensuring orders meet the minimum requirements. The form also emphasizes the importance of faxing for security reasons and strictly prohibits e-mail submissions to safeguard sensitive information. Payment options are versatile, accommodating credit cards up to a certain limit, ACH transfers exclusively in the U.S., and traditional methods like company checks or money orders. The terms and conditions outlined ensure all parties understand the transactions are final, highlighting that the cards, which can be used in several territories including the United States and Canada, are shipped inactive for security reasons and require activation upon receipt. This form demonstrates a thorough process designed to meet the various needs of purchasers while maintaining a high level of security and convenience for Subway card transactions.

Form NameSubway Certificate Format Form
Form Length1 pages
Fillable fields83
Avg. time to fill out16 min 55 sec
Other namessubway on line order form, subway order form, subway pickup order form, subway gift card order form

Form Preview Example


Please fax your completed form to VPS at 305.670.9586 | DO NOT E-MAIL THIS FORM

Purchaser Information

New Client


Order Date: _____ / _____ / ______ PO#: _______________________

Name: ____________________________________________________

Company Name: ___________________________________________

Address: __________________________________________________

Address: __________________________________________________

City: ___________________ State: _____________ Zip: ____________

Phone: __________________ E-Mail: ___________________________

Federal Tax ID/BN# (required for fundraisers): _______________________________

Referring SUBWAY Store # ____________

Ordering Information

Min. Order: 10 Cards | Min. Card Load: $5 | Min. Total Order: $250 | Max. Card Load: $100

BULK ORDER DISCOUNT - Save 2% on any order of $5,000 or more.* FUNDRAISER BULK DISCOUNT - Save 6% on any order of $500 or more.* Must provide a valid 501(c)(3) Tax Exempt #________________

*Not applicable on purchases made with a credit card

When ordering multiple currencies, please submit separate order forms for each currency.

Cards will be loaded with either U.S. or Canadian Dollars however, cards can be used in either country.

The Point-of-Sale system will automatically convert currency at the time of transaction based on established exchange rates. **Bilingual Cards are intended for use in Canada.

Specify Funds To Be Loaded








United States (English)

Card Load Denom.

Line Total


Canada (English/French)

($5 - $100)

(Quantity x Denom.)



Envelope Item Description

Price Per Pack of 50

Line Total



(Quantity x Price)







U.S. Green Bow Envelope












Canada Red Bow Envelope
















Ground Delivery (1-6 Days)












Next Business Day

Under 250 Cards



Orders must be received by 11:00 am Eastern




251 - 2500 Cards



for same day shipping. Applies to shipping only within




continental United States






2501 - 5000 Cards















Shipping Information

Card Total



Allow 2-3 days for order processing prior to shipping.







Shipping is available to one address only.

Less Discount



Orders are not processed until payment is conmed.




*Overnight orders must be receieved no later than 11:00 am

Order Total



Eastern for order to be processed for delivery.






Authorized Signature

Signature _____________________________ Title ________________

Company __________________________ Date ____ / ____ / _______

Terms & Conditions

By signing the above you agree to purchase the cards speciied in this order. SUBWAY® Cards are issued by Value Pay Services

LLC and may only be used for purchases at participating SUBWAY® restaurants. Unless the Card is registered online at, remaining balances on lost, stolen or damaged Cards cannot be replaced or refunded.

Questions? Please contact Value Pay Services (VPS) at 786-270-1273

Shipping Information

Same as Customer Information Name: ____________________________________________________

Company Name: ___________________________________________

Address: __________________________________________________

Address: __________________________________________________

City: ___________________ State: _____________ Zip: ____________

Phone: __________________ E-Mail: ___________________________

Payment Information

Credit Card Payment*

* (Limit $5,000. For orders over this amount please use another payment method.)





Name on Card: _____________________________________________

Address: __________________________________________________

Address: __________________________________________________

City: ___________________ State: _____________ Zip: ____________

Phone: __________________ E-Mail: ___________________________

Card #: ____________________________________________________

Expiration #: _____ / ______Security #: _____________

Authorized Signature: _______________________________________



* (Fax to 305.670.9586)


Account #: _____________________ ABA#: _____________________

Name on Account: __________________________________________

Authorized Signature: _______________________________________

I hearby authorize VPS LLC to initiate a debit transaction for the order total amount from the account speciove.


Program Description: ________________________________________

Market #: __________________ Program Timing: _________________


Make Checks Payable to: Value Pay Services

Mail Order Form with payment to:


Value Pay Services LLC | ATTN: Corporate Sales 9200 S. Dadeland Blvd. Suite 705 | Miami, FL 33156

* Orders paid by check will not be processed until funds have cleared the bank (7-10 days)

All orders are NOT processed until payment is conmed. All bulk order Card sales are . No return and no refunds. Cards

are shipped inactive as a safeguard against unauthorized use in the event cards are lost or stolen. Buyer is required to submit an activation request form to VPS to conm delivery of order so that cards can be activated prior to use. Card activation takes

24-48 business hours from VPS’ receipt of your activation form. Card balances do not expire or decline with non-use nor are there any fees or service charges associated with dormancy. SUBWAY® Cards can be used in the United States, Canada, Puerto Rico, Guam and Saipan at this time.

When, where and how will these cards be used or distributed and will there be any promotional or marketing materials created?

Any materials created by you which feature the SUBWAY® logos, Cards, Menu Items, or other proprietary images must be submitted to VPS for approval prior to their use or distribution. Submit to:

Internal VPS use only 501(c)(3) Tax Exempt # Verition IPC: _________________________