Customer Billing Information
|
|
First Name:
|
|
|
Last Name:
|
|
|
Email Address:
|
|
|
Daytime telephone:
|
|
|
Fax telephone:
|
|
|
Street Address:
|
|
|
|
|
|
City:
|
|
|
State:
|
|
|
Province:
|
|
|
ZIP/Postal:
|
|
|
Country:
|
|
Shipping Address
<>(If different from billing address above)<>
|
|
Ship to First Name:
|
|
|
Ship to Last Name:
|
|
|
Ship to Email Address:
|
|
|
Ship to Address:
|
|
|
|
|
|
Ship to City:
|
|
|
Ship to State:
|
|
|
Ship to Province:
|
|
|
Ship to ZIP/Postal:
|
|
|
Ship to Country:
|
|
|
Ship to telephone:
|
|
Shipping Information
Actual shipping fees may vary depending on destination and total order weight.
|
|
|
Actual shipping fees may vary depending on total order weight.
Payment Information
(You MUST click a circle below
to indicate method of payment)
|
Off-Line >>
|
- Check or Money order
(via US Snail Mail)
|
Credit Card Order Info
(If paying by credit card)
|
Please Select One:
|
|
|
Name on Card:
|
(exactly as it appears on card)
|
|
Credit Card Number:
|
(xxxx-xxxx-xxxx-xxxx)
|
|
Expiration Date:
|
/
|
Complete Order
|
|
Please include your 3-digit security code from the back of your credit card in the comment box below.
|
Special Instructions, comments or questions.
|
|
Please check your email address and other input carefully before clicking "Order >>".
|
|
|
READ THIS BEFORE YOU PUSH "ORDER" =>
IF you get a Security Warning asking if you want to view
only the content that was delivered securely, in IE click "NO"-
Firefox Warning may ask "Are you sure you want to continue sending this information?" click "CONTINUE"-
NEVER ASK TO SEE ONLY THE SECURE CONTENT!
Otherwise, your order will NOT be visible to YOU OR ME!
The following screen is your printable receipt; no personal info is presented, just the details of your order and our contact info.
|
|