Order Form

You can order many different ways!
Fill out this order form and then: print it out on your printer and fax/mail it to us at 1-623-516-8726 or press the Order button and email it direct. If you do not wish to transmit your *credit card information over the Internet, please indicate a time when it is best to call you to confirm your order and get your *credit card information. 

You may always place your order by calling us at 1-623-516-8640. Place your order with one of our sales people or simply leave your order on our answering machine after hours. 

 
Please fill in the following information and either print it out and fax/mail or press the "ORDER" button to email it to us.
name
       billing address  
shipping address
city
state
zip
country
email
telephone
best time to call
Drivers license#
Method of Payment (Must be in $US)        Read below

Expiration Date  Card Account # 
Name of Issuing Bank 
Name of Card Holder 
Important notice:  *Payments from out of  the country (USA)

                                           Must be prepaid with wire transfer.

                                        (We will no longer be able to accept credit  cards)  effective 10/02/02 thank-you

                              ~  In the USA credit card orders must accompany,  current address, and driver's license. ~  

 


 
 
 
 

Quantity Order # (if known) Color (if applicable) Description Unit Price Total
Subtotal
Shipping (call)
8.1 % Sales Tax
(AZ  Residents only)
Total Amount


 
For Product Information and Questions, Send e-mail to

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