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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
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IMPORTANT:
Copy complete account number from your MasterCard
Copy Number above your name on MasterCard
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Expiration date: _
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IMPORTANT:
Copy complete account number from your Discover Card
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Expiration date:
_
AUTHORIZED
SIGNATURE
Prices are subject to change without notice.
Print or type your name and
address clearly.
Name-
Street:
City:
State:
Apt:
Zip:
A complete and correct order will
save you days of waiting.
Please
make
sure that both
sides
of this form have been fdled
out completely.
• Allow 4 weeks for delivery.
• All accessories
are subject
to availability.
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