Credit Card Info

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IF you have NOT submitted an order or received a quotation:
- Please go to: Quotes/Orders Form,
- You may return to this page at the completion of that form,
- or wait for a formal quotation and instructions.
If you have already received a quote or were directed here:
- Continue to fill out the form.

If you have completed the above form you do not have to repeat ALL the information.
DO include your Email address and phone number and
DO fill out Billing address if different from your shipping address on the other form.
It is NOT necessary to include your shipping address again if it was complete on the order form.

This is a correction Do not check if this is your first entry

Day Telephone

Credit Card to use:

Credit Card # Expires

CVV # For visual explanation: CVVsend.htm BUT please return and submit your CVV through THIS form!

For American Express::: 4 digits on front of card, above and to right of card number.
For VISA/MASTERCARD::: LAST 3 digits in the signature box on the back of the card..
For Discover::: Also last 3 digits in signature box.

Cardholder's Name

Organization

Billing Phone

Billing Address

Address (continued)

City State/Province

Zip/Postal Code: Country

Shipping Address

Ship to City Ship to State/Province

Ship to Zip/Postal Code: Ship to Country

Preferred Shipping Carrier: Please specify UPS, Fedex, U.S. Mail or name of another carrier

Incoming shipping to us for items not in current stock:

Please Add: Rush or Regular: example: UPS-RED (Rush)

Outgoing shipping to you:

PLEASE NOTE: For most orders your credit card will not be charged until shipment is made. We will notify you if unusual conditions exist for your order. You will receive an invoice and credit card receipt with your shipment.

09/13/07