Credit Card Authorization Form(Please print this page, complete the information and fax it to the number listed to the right. Your order will not be processed until we receive this information.)
4660 SAINT ANDREWS AVE BUENA PARK CA 90621
Tel: 231-268-8253 Fax:
|Name (as stated on card)|
|Credit Card Type||
|Credit Card #|
(The CVV is the 3 digit number located on the back of your card)
Note: In the case of AMEX the CVV is the 4 digit number on the front of the card.