Paypalﾇ倣�ﾇｵﾇ淺ﾃﾉNﾉ衙WﾉbﾉgﾉJﾅ[ﾉhﾇﾃ鷆鍄ﾇ�ﾇﾕﾇｴﾇﾌﾇ�ﾇ滉ｻ�Pﾇ寡�ﾅB

ﾇﾐﾇｽ簗��ﾇﾃVisa MasterﾇﾃﾉAﾉCﾉRﾉ�ﾇ碧Nﾉ菲bﾉNﾇｵﾇﾐﾇ�ﾅB

迚鞣ﾇﾃﾉyﾅ[ﾉWﾅA��艘 US$ﾇ菩ｸﾇﾍﾅA
Paypalﾇﾃ蝴鄙ﾇﾃﾇｻﾇ｢麝ﾇﾕ竊絖ﾇ碧Nﾉ菲bﾉNﾅB
ﾅuIf you do not currently have a PayPal accountﾅv

鵈ﾇﾃﾉyﾅ[ﾉWﾅA簗��ﾇ�ﾇｩﾇﾌﾇﾋﾇﾐﾇ�ﾅB

1ﾅjCard Type:ﾅiﾉNﾉ衙WﾉbﾉgﾉJﾅ[ﾉhﾇﾃﾉ^ﾉCﾉvﾅjﾇ簿Iﾇ局ﾐﾇ�ﾅB
Visa MasterCard Discover American Express

2) SELECT ﾅi�Iﾇ固j

3ﾅjCredit Card Number:ﾉNﾉ衙WﾉgﾉJﾅ[ﾉh ﾉiﾉ�ﾉoﾅ[ﾇ菩ｸ�ﾕﾅ@ﾅiﾅ[ﾅjﾉnﾉCﾉtﾉHﾉ�ﾇﾕ霆��ﾅB

4) Expiration Date:ﾅiﾉJﾅ[ﾉhﾇﾃ苹蠢��ﾇﾍﾇﾃ裨 / �Nﾅj

5) Card Verification Number(ﾉJﾅ[ﾉhﾇﾃ�ﾝﾅAﾉTﾉCﾉ�ﾇﾃ箍ﾇﾃ3袒ﾇﾃ��鴕ﾅj

6) First Name:ﾅ@ﾉJﾅ[ﾉhﾇ願ﾊﾇ｡ﾇ淺｢ﾇﾈ�ｺ�OﾅAHideki, Ichiro,

7) Last Name:ﾅ@ﾉJﾅ[ﾉhﾇ願ﾊﾇ｡ﾇ淺｢ﾇﾈ竦�ιﾃ�ｺ�OﾅAMatsui, Suzuki

8) Email Address: ﾉ衙Vﾅ[ﾉgﾇ壁ｱﾇﾃEmailﾇ危�ﾇﾋﾇﾐﾇ�ﾅB

9) Credit Card Billing Address: ﾉNﾉ衙WﾉbﾉgﾉJﾅ[ﾉhﾇﾃ�跚ﾗ齏ﾇ���ﾇﾁﾇﾍﾇ淺どﾈﾅA鏤鞴ﾅB

10) Country:�呶{ﾇ痛Aﾉﾅﾉ菲Jﾇｻﾇｫﾇ簿Iﾇ固B

SELECT ﾅi�Iﾇ固j

11) Address 1:

12) Address 2: (optional)ﾅiﾇｱﾇﾃ��ﾅA馮�pﾇｵﾇｻﾇど淺�ﾇﾊﾇ｢ﾅBﾅj

14ﾅjCity:ﾅ@

15) State:ﾅiﾉAﾉﾅﾉ菲Jﾇﾃ靉釿ﾅj

16) ZIP Code:ﾅiﾉAﾉﾅﾉ菲Jﾇﾃ�X���檎ﾜﾅj
(5 or 9 digits) 袒

Phone Number ﾅi籌鬲ﾇﾃ�d�b�檎ﾜﾇﾐﾇ�ﾇﾕ虍�暁Hﾅj

18) Home Telephone:(竦ﾇﾃ�d�b�檎ﾜﾅj

19) �千��\�hﾇﾃ獸ﾅA迴ﾇ雁ｩﾇｶﾇﾈ�檎ﾜﾅA�城�ﾇ頁A�ﾘﾇ症ﾊﾇｧﾇ岩Eﾇﾃ聟��ﾇ願�ﾇｴ鍄ﾇﾒﾇ俄�ﾇ�ﾇ｢ﾅB

20)Message to Seller (Optional) - ﾉﾅﾉbﾉZﾅ[ﾉW莉�Pﾇ岩p袁ﾇ寡ｮ齏ﾇｴ竊ﾇ�ﾇ｢ﾅB
�ｷﾅF
-------------------
Atlanta Tour 1/1/04
$100 , Advance Payment
Hideki Matsui
-------------------

21) Check Out(ﾉ`ﾉFﾉbﾉNﾉAﾉEﾉgﾅjﾇ碧Nﾉ菲bﾉNﾇｵﾇ溪�ﾇ�ﾇ｢ﾅB

菷�Sﾇ危�ﾇﾁﾇﾍﾇﾈﾇ�, Emailﾇﾃﾉ衙Vﾅ[ﾉgﾇ��ﾕﾇｴﾇﾐﾇ�ﾅB