Fax Order Form send to (1)208-361-0460
Print
this page and send this form to the above number
Fax Order Form send to (1)208-361-0460
Print
this page and send this form to the above number
| Quantity |
Product
|
Price
|
Subtotal
|
|
$
|
|||
|
|
|||
|
Shipping
and handling
|
$
8.95
|
||
|
Countries outside USA/Canada/Europe/Australia/NZ: Please add US$7.00 postal insurance to cover against lost/damaged goods. We cannot replace or refund your order unless this insurance is added to your total payment. (Only applicable OUTSIDE USA/Canada/Europe/Australia/NZ) |
|||
TOTAL US$ |
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|
All fields must be filled in for order to be processed (BLOCK, capital letters please) Name _________________________________________________________________ Address ________________________________________________________________ City ___________________________________________________________________ State ____________Postal/Zip ___________ Country _______________________ Telephone _____________________Email ________________________________ Card Number _______________________________________________________ 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: ___________________________________________________________ ___________________________________________________________ Signature ______________________________
|
| Fax
the complete form to 208-361-0460 Your payment receipt and order confirmation will be sent to your email address. Allow up to 5-10 days for delivery. Thank you for your custom! |