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Adding Funds To Your
Phone Translation Account

How Much Would You Like To Add To Your Account:

Amount:

First Name:
Last Name:
Email Address:
Mailing Address:
City:
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If you prefer to mail a check or money order please complete this form and submit it.
Then click on mail, fax or call in credit card number.



With Care Introductions

7227 North 16th Street, Suite 240
Phoenix, AZ 85020
(602) 553-8178
fax (602) 468-1119
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