Associate National Sales Form

AMC Theatres Associate Order Form

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 Name Last Name

Email Address: *

Phone Number:

Area Code Phone Number

Shipping Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Shipping Method:

Please allow at least one week for ground shipping

I would like to reload my gift card:

Yes No

Gift Card reload requests placed on Fridays before 10:00 AM CST will be reloaded before the end of the day.

If a gift card reload request is placed on Fridays after 10:00 AM CST it will be reloaded the next business day.

Other than Friday requests, reloads will be processed before the end of the next business day.

My gift card number is:

Only One Reload per Order

Gift Card Value:

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

Gift Card Design

Popcorn Gift Card

Number of Gift Cards:

For Reloads This Number is 1

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: *

USD Total Cost (Includes $2.50 for USPS shipping)

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

Signature *

Clear

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.