ACCOUNT INFORMATION

Some of our customers have expressed a certain "hesitation" about giving out credit card information over the Internet.  We completely understand and respect that concern, therefore, we are happy to offer a secure alternative to ordering online.

We can establish an account for you so that all you need to do is tell us what you want and we will ship it to you without you having to send credit card information on the Internet.  Here's how.

Just fill in the information on this page and print it.  Then either snail-mail, fax or phone it to us.  We'll keep it confidential in a paper file; not in a computer connected to the Internet.

When you're ready to order something, simply go through our shopping cart to place your order but don't enter your credit card information.  Instead, select check as your method of payment, tell us in the "special notes" section at the end of the form that you have an account with us and enter your password (we'll give you one when we receive your account application).  We'll look up your account information, verify we have a current credit card on file, bill it and ship your order.

Here's the account information we need to set up your account:

First Name:
Last Name:

Credit Card Billing Address:
City:                                        
State:                                      
Zip (US):                                
Country:                                 
 

Shipping Address:  
City:                        
State:                      
Zip (US):                
Country:                 


E-Mail Address:

Home Phone Number:
Work Phone Number:
Fax Number (if any):   

Visa ()     MasterCard ()    Discover ()   American Express ()

Full Name As It Appears On Your Credit Card   

Credit Card Number:            CVV2 #

Credit Card Expiration Date:

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