NAME:______________________________ ADDRESS:___________________________ CITY:______________________________ STATE:____________ ZIP:____________ COUNTRY:___________________________ HOME PHONE:________________________ DAYTIME PHONE:_____________________ FAX:_______________________________ EMAIL:_____________________________ 3 Catalog set is over 3 lbs. $6.00 check or credit card in the US
Foreign countries - email, call, fax or write for total (usually $30-$50) CARD TYPE: ___VISA ___MasterCard ___Discover ___AmericanExpress. CARD NUMBER: ________ _______ ________ ________ EXP DATE: _______ Verification Code________ Address as it shows on your credit card statement: ADDRESS:___________________________ ZIP CODE:__________________________ CARDHOLDER NAME: __________________________________ SIGNATURE: __________________________________
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