VisaMasterCard

Please provide the following ordering information:

Note:Do not use THE ENTER KEY (it will transmit this form prematurely).
Use Tab key or mouse to move from one space to another.

E-mail address

(Very Important)

QTY	ITEM #	DESCRIPTION	PRICE

(Additional items can be entered in the comments box at the bottom of this form)

Sales tax 7.75% of above total		Only for shipments to California
ALL SHIPPING IS FULLY INSURED
Total special shipping charges (if any) from item's description

Shipping charge from chart below		Leave this box blank- you do not pay this- if you have entered a special shipping charge above.

SHIPPING CHARGE CHART
	TOTAL MERCHANDISE AMOUNT
	Orders $99.99 and under	$8.95
	$100 - $200	$9.95
	$200+	$10.95
	Foreign orders	$19.95 minimum

CUSTOMER INFORMATION

Credit card
Name on card
Card number
Expiration date	Enter month/year only, as in 05/02
CVVC number		(These are the last three digits on the signature strip on back of card)

Please make sure the address you input below matches
the address that appears on your credit card statement.

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone

SHIPPING ADDRESS - ONLY IF DIFFERENT FROM ABOVE

Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country

COMMENTS
(Is this a layaway? Do you qualify for a free offer? Special Instructions?)

You may wish to print a copy of this form now for your records.

Please click the button below to submit your order,
then remember to send your check or money order to the address on the next page.

Order Form for Customers Paying by Visa or MasterCard