Tel: (770) 394-6727 | Email: sales@stargems.com

3850 Holcomb Bridge Rd., Suite #205, Norcross, GA - 30092

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TWO-WAY MESSAGING & REVIEWS ORDER FORM
Order Date
Store Name *
Contact Person Name *
Cellphone # *
Address *
City/State/Zip *
Store Phone # *
Email id *
PACKAGE DETAILS
Package
Price
Order
One Time Setup Fee
$150.00 AUD
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Monthly charges:
Recurring charge every month on the same card
$115.00 AUD
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Twilio Phone Number Purchase Per Month
$9.00 AUD
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Text Messaging per 100 messages ($0.08 AUD per text) * Your card will be charged when your Twilio balance reaches below $20 & will auto replenish automatically)
$8.00 AUD
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PAYMENT DETAILS
Method Of Payment (select one) *
Account # *
Expiry Date *
CVV Code *
Name as it appears on the card *
Address where card is registered *