New Customer ___ Current Customer ___
Name:___________________________________________________________
E-Mail:_______________________________________
(You will receive your shipping
confirmation via email, please make sure you enter your email address
correctly)
Address:_____________________________________________________________
(Sorry we do not ship to
P.O.Boxes)
City:_________________________________State/Province:____________________
Zip/postal Code:___________________
Country:_____________________________
Telephone:_________________________
Brand ______________________________ Style/Model#_______________________
Size:________________Color:________________________
Quantity:_____________ Price Each____________________
Visa____ , Mastercard____ , Amex____ , Discover____, Check/Money Order____
Credit Card number:____________________________________Expiration date:_____/_____
Credit Card Billing Address (if different from shipping address)
Address__________________________________________________________
City_______________________________State_________ Zip/Postal Code__________________________
Shipping
Method:(International
destinations outside the US, shipped registered mail
only)
___UPS Ground in most States $9.95 (5-7 days), ____ Alaska,
Hawaii, Puerto Rico, Guam $25.95
___UPS (2nd Day) $19.95___UPS (next day) $48.95, ___Registered Mail
$30.00
Note: 2nd Day and Next Day shipping are subject
to stock availability, special order items will have
longer lead time.