Method of Payment
METHOD OF PAYMENT Please do not send cash.
Check/Money Order enclosed (Payable to: KidCo, Inc.)
|
|
| VISA (13 or 16 digits) |
|
|
|
|
|
| Mastercard (16 Digits) | |||||||||||||||||
|
|
|
|
|
|
|
|
| |||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Mo. |
|
| Yr. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| ||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Credit card account number |
|
|
|
|
|
|
|
| Expiration date (required) | ||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
| |||||||||||||||||
Signature of cardholder |
|
|
|
|
|
|
|
|
| Date | |||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Please print name of cardholder |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| ||||||||||||
|
|
|
|
|
|
|
|
|
|
| |||||||||||||||||
Name |
|
|
|
|
|
|
|
|
| Day time phone no. | |||||||||||||||||
|
|
|
|
|
|
|
|
|
|
| |||||||||||||||||
Street address |
|
|
|
|
|
|
|
|
| Unit | |||||||||||||||||
|
|
|
|
|
|
|
|
|
| ||||||||||||||||||
City | State |
|
|
|
|
|
|
| Zip | ||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1013 Technology Way Libertyville, IL 60048-5349
SHIPPING AND HANDLING CHARGES If order includes wall covers, lock fittings, wall plates or vertical bars, add $8.00.
All others add $5.00.
Order amount | $ |
Shipping & handling | $ |
Total | $ |
15
