SelectsoftNow Credit
Card FAX Order
Please print all information clearly so we can process
your order correctly and quickly.
Payments are in U.S. funds only. Fax the completed
form to: 1-888-799-5913
1. Your name
______________________________________________________
and Email Address
________________________________________________
(this enables us to locate your customer account and send
email on your order's status)
2. Telephone Number: ___________________________________
(Only used if we need to contact you directly about the
order.)
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3.
Billing Address |
4.
Shipping Address U.S. Address
ONLY! |
(please
specify apartments, suite numbers, etc.)
5.
Product ID#
(See URL of Title) |
Product Name & Description |
How Many |
Price
Each |
Subtotal |
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Total (Free Shipping USA Only!)
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Thank you for your order! If you have questions, please
contact us at
Customer Service. We will send a confirmation email when
your order is processed and shipped. Please allow 10-14 business
days for U.S. orders. (Note: We currently do not accept any
international orders).
Please FAX your credit card order to:
1-888-799-5913
Credit Card #
________________________________________ ( Visa / MC /
Disc )
CSV Code: __________
(CSV is a 3 digit code on back of card for VISA/MC, none
for Discover. We Don't accept AMEX.)
Exp Date: ______/___________ (MM/YYYY)
Name on Card:
___________________________________________
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