Click the SUBMIT button when you have completed the form. The account will then be sent to the appropriate
Sales Representative for follow-up. Please allow 4-6 weeks following
the referral's installation date to receive the Visa gift card.
Visa prepaid card is issued by MetaBank, Member FDIC, pursuant to a license from Visa U.S.A. Inc. Cards are
issued in connection with a loyalty, award or promotion program. Card does not have cash access and can be
used at any merchants that accept Visa debit cards. Card valid up to 12 months, funds do not expire and may
be available after card expiration date, subject to applicable law. Country restrictions apply and are subject
to change. Card items, conditions, and limitations apply; monthly card account management and post-expiration
re-issuance fee may apply, see MyPrepaidCenter.com/site/visa-univ for details.