E-MAIL
(Important
for all orders - be sure to type correctly):
NAME (Your full name - as it appears
on your credit card):
ADDRESS
(billing address of your credit card):
CITY, STATE and ZIP:
Day/Eve/Fax PHONES: (Please
label each)
Ship to if different: (Not for credit card orders! Include C/O
if applicable)
PLEASE SEND ME THE FOLLOWING ITEMS:
Write over any defaults as desired.
Please include [QUANTITY (otherwise 1 is assumed), SIZE, ITEM #, DESCRIPTION,
COLOR and PRICE].
1.
2.
3.
4.
5.
6.
7.
8.
SUBTOTAL
SALES TAX for:
COUNTY.
TOTAL PAYMENT
PAYMENT:
VISA/MASTERCARD
AMERICAN EXPRESS
DISCOVER
JCB
Credit Card Number:
Exp. Date:
CID#:
(REQUIRED - VISA, MC, DISCOVER: 3
digits located on back of card, AMEX: 4 digits on front above card
number)
__ PERSONAL CHECK (Print this form and mail to the address
below - We must hold order for 20 days)
__ MONEY ORDER (Print this form and mail to the address below
- with no delay)
__ WESTERN UNION
Visit WESTERN
UNION website and locate your closest agent. Complete the "To
Send Money" form. Give the agent the amount you require plus
the transaction fee (estimated $15 to $50 depending on country and
amount). Save your receipt with your Money Transfer Control Number
(MTCN) and enter to form below and any password required for pickup.
Messages or Special Instructions: Western
Union Control number, comments, messages and/or measurements as needed:
(measurements will not guarantee perfect fit but may help our expert
packers)
IMPORTANT: Credit card orders can only be shipped to credit card billing
address noted above.
