To fax your order then 
Print
this page and send this form to the above number.
Fax Order Form
USA
fax (1) 610-546-1964
To fax your order then
Print
this page and send this form to the above number.
Quantity |
Product
|
Price $
|
Subtotal
|
|
|
|||
|
|
|||
|
Shipping
and handling
|
$12.95
|
||
|
Total US$
|
|||
|
All fields must be filled in for order to
be processed Name _________________________________________________________________ Address _______________________________________________________________ City ___________________________________________________________________ State _________________ Postal/Zip ___________ Country ____________________ Telephone _________________________ Email _______________________________ Credit / Debit Card Number: (please write clearly) ___________________________________________________________ Card Verification Number ________ (Last 3 numbers on the back of the card) Card type (Visa/Master)____________ Expiry Date___________ US$____________ Card-holder billing address if different from above, otherwise leave blank: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ |
|
Fax
the complete form to (1) 610-546-1964
Your payment receipt and order confirmation will be sent to your email address Thank you for your custom! |