ORDER FORM (for FAX)
Those ordering by fax, please use this order form.
If you sent order form by e-mail,and then we sent Verification of Order already,
please wrigth down only part of METHOD OF PAYMENT.
ORDER
PRODUCT NO. PRODUCT NAME PRICE QUANTITY




SHIPPING METHOD
    SAL /SURFACE (Please indicate which one you prefer.)
METHOD OF PAYMENT

CREDIT CARD (Payment in one installment only)

    TYPE OF CREDIT CARD

      VISA / MASTERCARD (Please indicate which one.)

    Please use the same name that is used when making orders

    Verification numder
    (If you sent order form by e-mail,and then we sent Verification of Order):

    Card holder's name:
    Card Number:
    Expiration Date:
Customer's Name

Name:
Address:
Telephone Number:
Fax Number:
E-mail Address:
Birthdate:
Sex: M / F

Please write down any questions or comments you may have.