![](/images/new-backgrounds/1291873/291873243x1.webp)
Other Information
Charge your order on your VISA,MasterCard,
or Discover Card by filling in below
USE YOUR CREDIT CARD
IMPORTANT: Copy complete account number from your VISA card
Expiration date:
IMPORTANT: Copy complete account number from your MasterCard
Copy Number above your name on MasterCard |
|
|
|
| Expiration date: |
IMPORTANT: Copy complete account number from your Discover Card
Expiration date:
¤
s
r
r
TM
|
|
|
|
| AUTHORIZED SIGNATURE | ||||
|
|
|
| Prices are subject to change without notice. | |||||
|
|
|
|
|
|
|
|
|
|
Print or type your name and |
|
|
| A complete and correct order will | |||||
address clearly. |
|
|
| save you days of waiting. | |||||
Name: |
|
|
|
|
|
| |||
|
|
|
|
|
| ||||
Street: |
|
|
|
|
|
| |||
|
| Apt: |
|
| |||||
|
|
|
|
|
|
|
| ||
City: |
|
|
|
|
|
|
| ||
|
|
| Zip: |
|
|
| |||
State: |
|
|
|
|
Please make sure that both sides of this form have been filled out completely.
Allow 4 weeks for delivery.
All accessories are subject to availability.
Detach Here
120 | Chapter 7 |