*SECURE SITE SUBMISSION FORM

Please  fill and submit all the requested information for us to process your order. And please include your  e-mail Address, or your submission order will not go through.

Mr. Mrs. Ms. Miss.:   *                         
First Name:   
  *
Last Name: 
 
* 


Street address:   
* 
City:       
*
State:    
*                                          
Zip postal code:
*                                         
Country:  
*  

Business Name and Address: (if mailed to business address)

Business Owner:  Mr. Mrs. Ms. Miss.:  *                         
Full Name:   
  *
Business Name: 
 
* 


Street address:   
* 
City:       
*
State:    
*                                          
Zip postal code:
*                                         
Country:  
*  

 

Enter Item:
Brand name/Company name:  
*   Other:     

Enter style name, style number # and description:*

Adult, Child, Men or Ladies: *    Other:    

Color:    *   Other:   

Size: *   Other:     

Width:*     Other:  

Quantity:   *   Other:      

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Where did you find us: 


E-mail address: 
*

Phone:   *   (000)000-0000

Cell Phone:     (000)000-0000 Optional if needed.
Fax:   
(000)000-0000  Optional if available.

Shipping/preferred regular, priority or other  USPS or UPS:
*

We are Accepting  Master Card at this time. (there will be % Bank charges added to for charging M/C In and Out of US (International money order, Bank draft, Western Union in "US Currency) paid in advance only and there is no extra bank charges on check purchases made.


                
MasterCard number :   *
Card expiration date:  *
MasterCard security ID number:  *
(3 on the back of the card)
Name on credit card:       *

MasterCard  bill delivery address  (zip code): *  (must include full "bill delivery address" with zip code)

Date Needed (allowed time minimum 4-6 weeks, special orders are longer). Rush order if available extra charge. Delivery time 2 weeks if available (depends on ordered company's charging fee and the weight of the parcel)  10.00 Dollars or more extra:     

Please make sure that you have filled all the information correctly.  There is absolutely no returns of special  order. Please read our "return policy" If you made a mistake, please notify us immediately by  e-mail for cancellation and please keep us in save ,away from a junk mail in your computer that we won't be discarded.    

B1: Enter any comments you have about SUBMITTED  order, click ONCE only. 

  Enter  any comments.    

Thank you                 Home Page:  BACK   

Shipping charges will be billed according to the weight of the parcel and your State or Country address.