Associate National Sales Form

AMC Theatres Associate Order Form

Gift Card reload requests placed before 10:00 AM CT will be reloaded no loater than the next business day.

(internal use only)

I am a:*

TSC Employee ID:*

Field Employee ID:*

TSC ID NUMBERS:

Please allow two business days for Associate orders to be filled. Thank you for your patience.

FIELD ID NUMBERS:

Full Name:*

First NameLast Name

Email Address:*

Phone Number:

Area CodePhone Number

Shipping Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Shipping Method:

Please allow at least one week for ground shipping

I would like to reload my gift card:

YesNo

My gift card number is:

Only One Reload per Order

Gift Card Design

Popcorn Gift Card

Number of Gift Cards (1):

For Reloads This Number is 1

@ Gift Card $ Amount (1):

This is the dollar amount you want on each gift card.

**** I would like to order more gift cards at different denominations ****

YesNo

Number of Gift Cards (2):

for more than one denomination

@ Gift Card $ Amount (2):

This is the dollar amount you want on each gift card.

Gift Card Cost:

Black Tickets:

Black Tickets are $10.25 each

Black Ticket Cost:

Yellow Tickets:

Yellow Tickets are $8.50 each

Yellow Ticket Cost:

Number of Drink Show Snacks:

Drink Show Snacks are $4 each

Drink Show Snack Cost:

Number of Popcorn Show Snacks:

Popcorn Show Snacks are $4.50 Each

Popcorn Show Snack Cost:

Total Cost:

Credit Card Type:*

AMEX, Discover, MC, or VISA

MAKE A PAYMENT:*

USDTotal Cost (Please make sure any changes are reflected in the total.)

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Signature*

Please verify that you are human*

**Subject to surcharge for 3D, premium large screen format (e.g., IMAX®, AMC Prime®), alternative content, dine-in-theatres, film festivals, special theatrical presentations and premium services; location surcharges may also apply at select locations, including Disney and Universal properties operated by AMC. AMC reserves the right to change these terms and conditions without notice, including changes and additions to surcharge fees, restrictions or exclusions. For current terms and conditions, a complete listing of applicable surcharges, exclusions, AMC Theatre brands and restrictions, please visit www.amctheatres.com/exchange-tickets-terms. Minimum purchase requirement is per order.